In This Week’s Update:
- Happy Birthday ACA!
- New Resource to Advance Maternal Health Equity
- Inequities in Health Insurance Coverage and Access
- Creating Health System Accountability through Community Partnerships
- Preventive Services Use Among People With Private Insurance
- State updates: AZ, CA, CO, CT, KS, KY, LA, MD, NM, OK & RI
Happy Birthday ACA!
Last week marked the 13th anniversary of the Affordable Care Act (ACA). In recognition of the anniversary, CMS highlighted record-breaking coverage in the 2023 open enrollment period, during which nearly 16.4 million consumers selected or were automatically re-enrolled in health insurance coverage through HealthCare.gov Marketplaces and State-Based Marketplaces. HHS also released a report that shows more than 40 million people are currently enrolled in Marketplace or Medicaid expansion coverage related to provisions of the ACA—the highest total on record. This op-ed, written by Heather Howard at State Health & Value Strategies (SHVS), reflects on the ACA entering its teenage years and its successes as well as its potential to grow and expand coverage.
Also last week, SHVS published new and updated resources for states:
- A new expert perspective summarizes the proposed revisions to the federal standards for collecting race and ethnicity that are currently out for comment, and provides considerations for states interested in submitting comments.
- A new expert perspective details how state Medicaid agencies and Marketplaces can leverage digital channels and data as part of their overall outreach and communications efforts.
- And to help states better understand the enrollment trends during the COVID-19 pandemic, SHVS has updated our Databook and published a companion issue brief that provides a state-level look at Medicaid enrollment trends and profiles enrollment data that is both more recent and more detailed than the published CMS enrollment data.
New Resource to Advance Maternal Health Equity
Raising the Bar offers a practical guide for healthcare provider institutions to improve equity and excellence in maternal health. The new report provides role-specific operational guidance to strengthen clinical care and advance maternal health, including quality measures and payment model reforms.
Creating Health System Accountability through Community Partnerships
Healthcare systems across the United States are increasingly focused on opportunities to achieve greater health equity. A report from the Center for Health Care Strategies (CHCS) outlines practical approaches to guide health systems in more meaningfully involving community members and being more accountable to the communities they serve. These strategies draw from a national exploration made possible by the Robert Wood Johnson Foundation and led by CHCS in partnership with Center for Health + Justice Transformation. To understand opportunities for developing more community-driven and accountable health systems, the partner organizations conducted a literature review and interviews with safety-net health systems, community-based organizations, and subject matter experts. The report summarizes key findings for developing health systems that are more accountable to communities and outlines practical considerations to guide health systems in shifting the power balance to involve community members in decision-making processes.
State updates: AZ, CA, CO, CT, KS, KY, LA, MD, NM, OK & RI
- Arizona – The Arizona Department of Health Services and the Arizona Health Care Cost Containment System announced that they are partnering on a new public awareness campaign called “Hope Always Answers” that promotes the 988 suicide and crisis lifeline. Assets for the new public awareness campaign are available in English and Spanish at no cost, for use by local county health departments and community partners.
- The Department of Health Care Services announced that it submitted a section 1902(e)(14) waiver request to renew eligibility for non-Modified Adjusted Gross Income (non-MAGI) populations without requesting additional information and to disregard increases in assets since the last Medi-Cal (Medicaid) determination. This waiver—which will be effective retroactive to March 1, 2023 through December 31, 2023—will increase the number of non-MAGI-based individuals who will have their coverage renewed during unwinding. California is planning to eliminate the asset limit entirely on January 1, 2024.
- Governor Gavin Newsom announced that CalRx has secured a contract with a manufacturer (CIVICA) to make $30 insulin to all who need it. This will bring down the price of insulin by about 90%, saving cash-paying patients between $2,000 and $4,000 annually. Californians can learn more about CalRx on the newly launched website. The governor also announced that California will seek to manufacture its own Naloxone.
- Colorado – Executive Director Kim Bimestefer of the Colorado Department of Health Care Policy & Financing (HCPF) issued a message to stakeholders on the end of the Medicaid continuous coverage requirement, describing the state’s compliance with CMS’ criteria for obtaining enhanced federal matching funds. The notice also shares communication resources, such as awareness posters and social media images, and encourages stakeholders’ active engagement in raising Medicaid enrollees’ awareness of the upcoming renewals and in helping connect those who no longer qualify to other forms of coverage. Also, HCPF announced they began sending text message reminders to Medicaid members who need to complete renewal paperwork to see if they still qualify for health coverage.
- Connecticut – Governor Ned Lamont announced that his administration has taken measures to further expand access to affordable health insurance for personal care attendants (PCAs), who provide valuable services and support to more than 7,000 of Connecticut’s Medicaid enrollees so they can remain in their homes and communities. PCAs can apply for a new premium assistance benefit during a special enrollment period for coverage through Access Health CT, the state’s official health insurance Marketplace.
- Kansas – The Kansas Department of Health and Environment announced that they have increased communication with KanCare (Medicaid) enrollees, healthcare providers, and other stakeholder groups in regular contact with the enrollee community to share information regarding the resumption of eligibility reviews. In addition, KanCare has updated its website to make it easier for people enrolled in Medicaid to update their contact information and complete the verification process.
- Kentucky – Governor Andy Beshear signed a measure to expand access to healthcare services for Kentuckians. The measure, House Bill 75, also supports Kentucky’s hospitals by boosting Medicaid payment rates for outpatient procedures performed at hospitals. The law is expected to provide needed budgetary support for hospitals, especially the state’s rural healthcare facilities.
- Louisiana – The Louisiana Department of Health (LDH) announced that Louisiana Medicaid will start using text messages to send members important reminders about their health insurance coverage. These text messages may include reminders about renewals and reminders to update contact information. LDH also announced a series of webinars for providers on the end of Medicaid continuous coverage and the restart of Medicaid renewals.
- Maryland – The Maryland Department of Health (MDH) announced that it will maintain the current Medicaid reimbursement rates for evaluation and management (E&M) services for enrolled Marylanders. Typically, Medicaid payment rates to providers for E&M visits are lower when compared to Medicare. The Medicare Physician Fee Schedule recently decreased E&M rates by 2%, causing Medicaid rates to become slightly higher. MDH’s goal in maintaining the current Medicaid reimbursement rates is to enable doctors to provide the same access to care to Medicaid patients as it does to Medicare patients.
- New Mexico – Governor Lujan Grisham signed into law House Bill 7, the Reproductive and Gender-Affirming Healthcare Act, which prohibits public bodies, including local municipalities, from denying, restricting, or discriminating against an individual’s right to use or refuse reproductive healthcare or healthcare related to gender.
- Oklahoma – The U.S. Department of Health and Human Services approved the extension of Medicaid coverage for 12 months after pregnancy in Oklahoma. As a result, up to an additional 14,000 people in Oklahoma will be eligible for Medicaid for a full year after pregnancy. In total, an estimated 462,000 Americans across 30 states and the District of Columbia have now expanded access to postpartum coverage. As a reminder, SHVS published an issue brief on the American Rescue Plan Act’s option to extend postpartum coverage.
- Rhode Island – Governor Dan McKee announced that the state expects about half of Medicaid renewals to be passive and require no action from the enrollee. The state is working with community partners and advocates to conduct outreach efforts ahead of eligibility redeterminations. Those who cannot be passively renewed will be broken down into monthly renewals beginning April 1, with the last group of renewals beginning in March 2024. Of note, families with children will not start their Medicaid renewal process until December. The state is also offering mini grants to community partners to reach those most at risk during the renewal process.