March 4 Update

In This Week’s Update:

  • Medicaid and CHIP enrollment numbers
  • New Racial Equity Community of Practice
  • Supporting Postpartum Mental Health
  • State updates: AK, AR, CO, MA, ME, MI, MN, MT, NC, ND, NM, NY, OR & WI


Medicaid and CHIP Enrollment Numbers
Last week, CMS released the latest enrollment figures for Medicaid and CHIP. As of November 2023, 85,815,827 people were enrolled in Medicaid and CHIP, a decrease of a little over 1.5 million compared to October 2023. The decline in the number of individuals enrolled in Medicaid and CHIP is attributable to the on-going unwinding of the Medicaid continuous coverage requirement. As a reminder, State Health and Value Strategies has a resource page dedicated to unwinding to support states as they implement unwinding and template communications resources, including recently updated messages to encourage renewal completions which are available in 15 additional languages besides English. Updates follow.


New Nationwide Racial Equity Community of Practice
State of Equity, Race Forward, the Government Alliance on Race and Equity (GARE), and Needle Strategies are working collaboratively to facilitate a community of practice for state government staff who are committed to and engaged in racial equity work. The community of practice will be a space for state government practitioners to: take a deeper dive into what it means to embed racial equity into government services; connect to a national network of people in state government who are leading and participating in racial equity efforts; engage in ongoing learning and development from best practices in the field and content experts; and provide and receive feedback from a community of peers who can offer additional support and resources. There is no fee to participate in the Community of Practice, which will launch in March 2024. To learn more, see this overview and sign-up here. Questions and inquiries can be addressed to Dalila Madison Almquist at

Supporting Postpartum Mental Health 
On March 12, 2024 at 2:00 p.m. ET, the Georgetown University Center for Children and Families (CCF) will host a webinar on their recently published report, State Opportunities to Support Mental Health of Mothers and Babies During the 12-Month Postpartum Period, which recommends concrete steps state Medicaid agencies can take to address mental health among mothers and infants in the postpartum year. Recommendations, which also seek to advance health equity at the community and state levels, were shaped and prioritized at a meeting of Medicaid policy and maternal and child health practice experts hosted by CCF in fall 2023 with support from the Perigee Fund.

Medicaid and CHIP Managed Care Quality Improvement Videos
The Center for Medicaid and CHIP Services (CMCS) released two new videos: Using State Managed Care Quality Strategies for Quality Improvement in Medicaid and CHIP and Using Managed Care External Quality Review for Quality Improvement in Medicaid and CHIP. These new videos describe two managed care quality oversight activities—quality strategies (QS) and external quality review (EQR) technical reports—and how state Medicaid and CHIP programs can use them to inform and support quality improvement (QI) initiatives. States can use these videos to: onboard state Medicaid and CHIP managed care and QI staff; refresh Medicaid and CHIP staff as they prepare to revise their QS, review their annual EQR technical report, or launch a QI project; and introduce QS and EQR to Medicaid and CHIP program QI partners. The new videos and other managed care QI technical assistance resources are available.


State updates: AK, AR, CO, MA, ME, MI, MN, MT, NC, ND, NM, NY, OR & WI

  • Alaska – CMS approved a postpartum coverage extension state plan amendment (SPA) for Alaska. This SPA approval will extend comprehensive coverage after pregnancy through Medicaid and CHIP for a full 12 months. Alaska is the 44th state, including D.C. and the U.S. Virgin Islands that have extended postpartum Medicaid coverage to a full year. As a reminder, SHVS published an issue brief on the American Rescue Plan option to extend postpartum coverage.
  • Arkansas – Arkansas submitted a request for a new Medicaid section 1115 demonstration which would provide coverage of all medically necessary services for the first 90 days at the beginning of incarceration or admission to an Institution for Mental Disease (IMD) and the 90 days immediately prior to release from either setting. The state will also provide a pre-release benefit package of case management and care coordination services, medication-assisted treatment services, and a 30-day supply of prescription drugs to individuals leaving carceral settings.
  • Colorado
  • Maine
    • Responding to a pharmacy vendor network disruption, the Department of Health and Human Services (DHHS) Office of MaineCare Services announced that it has authorized pharmacies to provide prescriptions for up to 30 days to help MaineCare members access needed medications. This is in response to the national issue with Change Healthcare, the out-of-state vendor that operates the pharmacy claims system for Maine’s Medicaid program. DHHS asks pharmacies to neither turn away nor ask enrollees to pay out-of-pocket for prescriptions that are covered by MaineCare and DHHS will pay all eligible claims submitted once the system is operational again.
    •, the state’s official health insurance Marketplace, released its 2024 Open Enrollment Overview report. The report provides an overview of enrollment trends, affordability of health insurance coverage through the Marketplace and key operational and marketing changes that took place during the 2024 open enrollment.
  • Massachusetts – The Massachusetts Health Connector, the state’s official health insurance Marketplace, released its Strategic Plan for 2024 through 2028. The strategic plan is intended to serve as a roadmap for the Health Connector, providing a framework to organize agency initiatives, infrastructure, policies, and practices to ensure continued success and maximum public impact.
  • Michigan – The Michigan Department of Health and Human Services has awarded a three-year contract for a technical assistance program for up to 24 county jails seeking to implement or expand medications for opioid-use disorder (MOUD) programs. Participating counties will receive grants up to $25,000 to cover associated costs. This project is funded through opioid settlement dollars and is designed to address significant overdose risks in incarcerated populations during and following incarceration by increasing access to MOUD programs.
  • Minnesota – Minnesota submitted a request to extend the Medicaid section 1115 demonstration entitled “Minnesota Substance Use Disorder (SUD) System Reform” for an additional five years. This demonstration provides federal Medicaid funds for enrollees receiving SUD treatment in facilities that meet the federal definition of an IMD.
  • Montana – Governor Greg Gianforte and Department of Public Health and Human Services (DPHHS) Director Charlie Brereton announced an expansion of behavioral health services for Montanans. The announcement comes after CMS approved a waiver for DPHHS to provide three new Medicaid-funded services as part of the state’s Healing and Ending Addiction through Recovery and Treatment (HEART) program. The new services will help Montanans struggling with substance-use and mental health conditions find and keep stable housing, provide incentives to those meeting treatment goals, and provide services to incarcerated individuals in the 30 days before their release from the state prison system.
  • New Mexico – The New Mexico Human Services Department announced the appointment of Dana Flannery as the new director of the New Mexico Medicaid program. Congrats Dana!
  • New York – Governor Kathy Hochul announced $20 million in start-up funding for school-based mental health clinics and launched a rolling application, which will make it easier for interested schools to access state funding. Governor Hochul also announced that her Youth Mental Health Advisory Board will begin accepting applications from interested children and teenagers.
  • North Carolina – The North Carolina Department of Health and Human Services will pursue participation in the new CMS Cell and Gene Therapy (CGT) Access Model, which will first focus on access to recently approved gene therapies for Medicaid enrollees living with sickle cell disease, a genetic blood disorder that disproportionately impacts Black Americans. The CGT Access Model aims to improve health outcomes for people by supporting outcomes-based agreements that will provide for treatments within a framework that lowers prices for states and ties payment to outcomes.
  • North Dakota – North Dakota Health and Human Services has received approval from CMS to expand access and add services to the state’s Medicaid autism spectrum disorder waiver. The approved waiver adds 195 slots and increases the qualifying age of children who can be served from age 15 through age 17. Waiver changes include an enhanced reimbursement rate to provide case management in rural areas and provider rate increases.
  • Oregon – CMS approved a new section 1115 demonstration for Oregon which will enable the state to receive federal financial participation to provide a limited set of home and community-based services to older adults or adults with disabilities. CMS is also authorizing continuous eligibility for individuals enrolled in the demonstration to support consistent coverage and continuity of care by keeping individuals enrolled for 24 months regardless of income fluctuations or other changes.
  • Wisconsin – The Wisconsin Office of Children’s Mental Health released an infant and toddler mental health fact sheet. The fact sheet is aimed at parents and caregivers, early childhood educators and policymakers.