In This Week’s Update:

• New SHVS Resources on the American Rescue Plan
• ACA Anniversary
• Expanding COVID-19 Vaccine Access
• COVID-19 State Updates: MA, MI, NC, NY, OR, RI, WI
• Other State Updates: AK, CO, DE, MD, ME, MN, MT, HI, MN, NC, ND, NH, NJ, NV, NY, OR, PA, RI, WI
• Webinars on the American Rescue Plan
• Enrollment in Nongroup Health Insurance by Income Group
• OEP Experiences in NJ and PA

 

New SHVS Resources on the American Rescue Plan

Last week, State Health and Value Strategies (SHVS) released two new resources for states on the American Rescue Plan. The first, a Timeline of Key Provisions in the American Rescue Plan Act of 2021, provides the start and end dates for key health care provisions to help states plan for implementation and future policymaking. The second, COBRA Assistance in the American Rescue Plan Act: A Guide for States, provides a short overview of COBRA and mini-COBRA, the major elements of the COBRA Assistance program in the new law, and considerations for state policymakers related to the program.

 

ACA Anniversary

This week also marked the 11-year anniversary of the Affordable Care Act (ACA) being signed into law. In recognition of the anniversary, SHVS program director Heather Howard coauthored an op-ed where she reflected on how the ACA has been remarkably resilient, has provided a vital lifeline during the COVID-19 pandemic, and can be a tool for advancing health equity.

 

Expanding COVID-19 Vaccine Access

The Biden-Harris administration announced a series of actions to expand access to COVID-19 vaccines to the communities that have been at highest risk across the country. With funding in large part from the American Rescue Plan, the U.S. Department of Health and Human Services will invest nearly $10 billion to expand access to vaccines and better serve communities of color, rural areas, low-income populations, and other communities experiencing the disproportionate impact of COVID-19. This funding will expand access to vaccines for underresourced communities and increase vaccine confidence across the country. SHVS has also updated its expert perspective titled Ensuring Equity: State Strategies for Monitoring COVID-19 Vaccination Rates by Race and Other Priority Populations, which reviews the data states are currently publicly reporting related to vaccine administration and provides an interactive map that highlights how states are reporting vaccine administration data breakdowns by age, gender, race, ethnicity, provider type, and level of geography.

 

COVID-19 State Updates: MA, MI, NC, NY, OR, RI, WI

• Massachusetts – The Massachusetts Health Connector announced that it will be able to provide hundreds of thousands of people with new and increased help to pay for their health insurance premiums as a result of the recently enacted American Rescue Plan, starting for May coverage.
• Michigan – The Michigan Department of Health and Human Services announced that approximately 350,000 Michigan families will continue to have access to additional food assistance benefits during March in response to the COVID-19 pandemic. Michigan previously approved the additional food assistance beginning in March 2020, and now it is being extended for March 2021 with approval from the U.S. Department of Agriculture Food and Nutrition Service.
• New York – Gov. Andrew Cuomo announced expanded tax credits are available through NY State of Health, New York’s health plan marketplace. In June 2021, NY State of Health will expand tax credits to tens of thousands of additional New Yorkers with higher incomes who, before the American Rescue Plan, did not qualify for financial assistance. Gov. Cuomo also announced that the 2021 open enrollment period will be extended through the end of this year.
• North Carolina
  • To help reach those who are in need of testing, the North Carolina Department of Health and Human Services, in partnership with LabCorp, is piloting a program to provide 35,000 no-cost, home test collection kits to North Carolinians receiving Food and Nutrition Services and/or who are disabled and experiencing barriers to getting tested.
  • Gov. Roy Cooper and North Carolina Health and Human Services Secretary Mandy K. Cohen announced the launch of a new public private partnership, “Healthier Together: Health Equity Action Network,” which will enhance the state’s work to deliver equitable access to vaccines. The Department of Health and Human Services also released a new biweekly equity data report to provide another avenue for transparency. 
• Oregon – The Oregon Health Authority announced that 1 million Oregonians have been vaccinated with one or more doses of the COVID-19 vaccine.
• Rhode Island – HealthSource RI’s special enrollment period has been extended through August 15, 2021, following President Biden’s decision to create another opportunity for Americans to sign up for health coverage. The extended deadline gives new and current customers a chance to receive new savings created by the American Rescue Plan. Eligible Rhode Islanders will receive increased tax credits to help reduce their monthly coverage costs thr­­­ough HealthSource RI.
• Wisconsin – The Wisconsin Department of Health Services launched a redesign of the vaccine distribution summary of its COVID-19 vaccine data page. The new allocation and administration dashboard displays key metrics related to Wisconsin’s COVID-19 vaccination program, including total doses administered by provider type.

 

Other State Updates: AK, CO, DE, MD, ME, MN, MT, HI, MN, NC, ND, NH, NJ, NV, NY, OR, PA, RI, WI

• Hawaii – The Hawaii Department of Human Services announced the extension of its QUEST Integration Medicaid managed care contracts. Implementation is slated to begin July 1, 2021, with contracts running to Dec. 31, 2026, with three additional optional years. The total contract worth, including optional years, is $17 billion.
• Minnesota – The Department of Human Services announced new federally funded Community Resource Hubs to help pregnant and parenting families with children ages eight and younger navigate Minnesota’s early childhood system. This shifts the burden of finding help from those seeking services to organizations that connect them with the supports they need. The $6 million outlay is part of a $26.7 million total investment that will occur over the next two years.
• Nevada – The Division of Health Care Financing and Policy released a request for proposals for the Nevada Medicaid and Children’s Health Insurance Program managed care program. Selected managed care organizations must also participate in the state-based ACA Exchange, providing at least one silver and one gold qualified health plan by 2024.
• New York – The state submitted a request for a three-year extension to its Medicaid Redesign Team (MRT) Section 1115 demonstration to the Centers for Medicare and Medicaid Services. New York is requesting two changes to MRT: carving out both nonemergency medical transportation and pharmacy coverage from managed care. The federal public comment period is open through April 23, 2021.
• North Carolina – To support the North Carolina Department of Health and Human Services’ goals to achieve health equity, NC Medicaid is introducing an enhanced payment to Carolina Access primary care practices serving enrollees from areas of the state with high poverty rates. These payments will be available for three months as a limited initiative from April to June 2021.
• Alaska, Colorado, Delaware, Maine, Maryland, Minnesota, Montana, New Hampshire, New Jersey, North Dakota, Oregon, Pennsylvania, Rhode Island and Wisconsin – The insurance commissioners in these 14 states sent a letter to the Center for Consumer Information and Insurance Oversight and the Department of the Treasury requesting that the agencies calculate each state’s final pass-through funding for their reinsurance programs by taking into account the changes in law resulting from the American Rescue Plan and the expected impact on federal spending. SHVS tracks state Section 1332 waiver activity via its map.

 

SHVS Webinars on the American Rescue Plan

SHVS held a three-part webinar series focused on the coverage provisions of the American Rescue Plan. The first webinar, The American Rescue Plan: An Overview of Private Insurance Provisions, explored changes to private insurance, including marketplaces. The second webinar, The American Rescue Plan: An Overview of Medicaid Provisions and State/Local Relief, reviewed key Medicaid provisions and state/local relief funding included in the COVID-19 relief package. And the third webinar, The American Rescue Plan: Communicating Affordability Provisions, discussed communication and messaging strategies to consumers so they can take full advantage of the affordability provisions in the law. Slide decks and recording of all of the webinars can be found on the SHVS website.

 

Enrollment in Nongroup Health Insurance by Income Group

The Brookings Institute released a paper that estimates how many nonelderly people in different income groups held marketplace coverage, off-marketplace coverage that qualifies as minimum essential coverage (MEC) under the ACA, or non-MEC nongroup policies (e.g., short-term limited duration plans), as well as how many lacked any coverage, in 2019. The paper highlights four principal findings regarding patterns of nongroup enrollment in 2019, including that the large majority of potential subsidy recipients who lacked MEC had incomes below 400 percent of the federal poverty level and at lower income levels, potential subsidy recipients who lacked MEC were typically uninsured, while at higher incomes many held non-MEC nongroup policies. The paper closes by making two recommendations for how data on enrollment in nongroup coverage could be improved in the future.

 

Rookie Report: How did New Jersey and Pennsylvania State Marketplaces Fare in Their Inaugural Enrollment Period?

A new blog post by Georgetown University’s Center on Health Insurance Reforms highlights the open enrollment period experiences in the two newest states with state-based marketplaces: New Jersey and Pennsylvania. Both states launched new marketplace websites in time for the recent open enrollment period (OEP) after seven enrollment cycles on the federal website, HealthCare.gov. New Jersey’s marketplace recorded a 9.4 percent increase in plan selections over the previous OEP, including a 21.4 percent increase in new enrollees, and Pennsylvania’s marketplace, “Pennie,” had a 1.8 percent increase in plan selections, including a 9.7 percent increase in new enrollees. In addition to transitioning to an state-based marketplace, both states have implemented a number of policies to shore up their individual health insurance markets and bolster enrollment, such as operating a reinsurance program using the ACA’s Section 1332 waivers to reduce premiums, and, in New Jersey’s case, enacting a state-level individual mandate and enhanced premium subsidies. The transition to a state-run enrollment platform provides additional opportunities to grow enrollment, including extending the window to sign up for coverage and investing in outreach and marketing efforts.