March 4 Update

In This Week’s Update:

  • Health Care News from Capitol Hill
  • New Pass-Through Funding Resources
  • State Updates: CO, ME, NE, PA, RI, VA and WA
  • New Early Childhood and Medicaid Initiative
  • Health Impact Assessments and Better Decision-making
  • Tracking Medicaid-Covered Prescriptions

News from Capitol Hill

Last week was a busy one on Capitol Hill as the future of health care was discussed. On Tuesday, the Senate Finance Committee held a hearing on drug pricing with testimony provided by seven pharmaceutical executives. For a roundup of the major takeaways from the hearing, the Washington Post’s Health 202 blog has an analysis. The hearing and a new health care reform proposal introduced in the House on Wednesday are explored in detail in last week’s What the Health podcast episode.

New Pass-Through Funding Resources

In case you missed it, last Thursday, the Center for Consumer Information & Insurance Oversight posted new materials and resources on calculating pass-through funding. The resources include a document detailing the federal calculation methodology, a frequently asked questions document, as well as state-specific premium data for 2019 pass-through calculations. As a reminder, SHVS continues to monitor state activity related to Section 1332 waiver applications on their website and they’ve recently updated their resources, including their application template, checklist, and issue brief, to reflect the latest federal guidance.

State updates: CO, ME, NE, PA, RI, VA and WA

  • Colorado
    • The Centers for Medicare & Medicaid Services (CMS) approved a Colorado State Plan Amendment that will allow the Department of Health Care Policy & Financing to negotiate supplemental rebate agreements involving value-based contracts with pharmaceutical companies.
    • A hearing on proposed legislation to implement a reinsurance program was held last week with a number of state officials testifying in support.
  • Maine – The Department of Health and Human Services is sharing the latest enrollment numbers for the state’s Medicaid expansion. As of March 1, 8,786 people have enrolled.
  • Nebraska – The Nebraska Department of Health and Human Services issued a notice of its intent to submit a State Plan Amendment (SPA) to define the Alternative Benefit Plan that will be used to expand Medicaid. Public comments on the proposed SPA are being accepted until March 29, 2019.
  • Pennsylvania – The Department of Human Services (DHS) released a report on the status of the state’s Medicaid expansion, which has been in place for four years. DHS also launched a Medicaid data dashboard which makes available data on total enrollment and utilization of screenings, in addition to other metrics.
  • Rhode Island – HealthSource RI, the state’s official health insurance marketplace, announced that during open enrollment for 2019, 32,486 customers enrolled and paid compared to 30,637 last year. In addition, the latest Rhode Island Health Information Survey shows that only 3.7 percent of Rhode Islanders were uninsured in 2018, down from 4.2 percent in 2016.
  • Virginia – To date 233,179 Virginians have enrolled in Medicaid expansion. On their Medicaid expansion Dashboard, the Department of Medical Assistance Services has a breakdown of enrollment by region, age, gender and family income.
  • Washington – The Washington Health Benefit Exchange, the state’s official health insurance marketplace, announced that more than 200,000 people purchased their 2019 health insurance coverage through Washington Healthplanfinder, the state’s online health insurance marketplace, during the most recent open enrollment period held November 1 through December 15 of last year.

National Initiative to Align Early Childhood and Medicaid to Improve Child Outcomes

The Center for Health Care Strategies (CHCS) have launched a new initiative, Aligning Early Childhood and Medicaid. In partnership with the National Association of Medicaid Directors and ZERO TO THREE, the multi-state initiative aims to improve the health and social outcomes of low-income infants, young children, and families through cross-agency collaboration. The new initiative, made possible through support from the Robert Wood Johnson Foundation, announced that eight states—Colorado, Minnesota, New Jersey, New York, Oregon, Rhode Island, Vermont, and Washington—will be participating in the initiative.

Study of Health Impact Assessments to Promote Healthier Decision- Making

The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, released findings from a study on a sample of health impact assessments (HIAs). HIAs are a tool that can help communities and decision-makers collaborate to identify the potential health effects of decisions in multiple sectors, how those impacts might disproportionately affect different racial, income, geographic, and other groups, and how that distribution can influence health outcomes. The research team used an online questionnaire and phone interviews to explore how the HIAs affected social determinants of health and examine HIAs’ impact on two key drivers of health equity: resource allocation and community participation in decision-making.

Tracking Medicaid-Covered Prescriptions to Treat Opioid Use Disorder

State Medicaid programs are on the front lines of addressing the opioid crisis by expanding access to evidence-based treatment. A new tool by the Urban Institute, tracks national and state data on two types of medications used to treat opioid use disorder (buprenorphine and naltrexone) and one medication used to treat opioid overdoses (naloxone). The tool analyzes Medicaid prescribing and spending patterns nationally and by state. The data will be updated quarterly and feature emerging state and national trends and policy implications.