March 6 Update

In This Week’s Update:

  • State-by-State Unwinding Dates
  • Medicaid Enrollment Growth: Who May Be at Risk
  • O’Neil Institute Healthcare Litigation Tracker
  • Unwinding Home and Community-Based Services PHE Flexibilities
  • State updates: IA, IL, MA, MN, NC, NV, NY, PA, SC & VA


State-by-State Unwinding Dates

Last week, CMS published a chart that lists the anticipated timelines for initiating unwinding-related renewals for each state and territory as of February 24. The chart details the expected first month for each state or territory’s unwinding-related renewals, as well as the anticipated effective date for the first procedural terminations. As a reminder, SHVS has a one-stop resource page with materials to support states as they plan for unwinding the Medicaid continuous coverage requirement.


Medicaid Enrollment Growth: Who May Be at Risk

A new analysis from the Kaiser Family Foundation estimates that enrollment in Medicaid and CHIP will have grown by 23.3 million enrollees, to nearly 95 million, by the end of March. That is when the federal continuous enrollment provision expires, and states can resume disenrollments, which have been paused since February 2020. Millions of enrollees are expected to be disenrolled over the next year, and the new estimates illustrate the extent to which enrollment could decline and who will be most affected. Over half of the 23.3 million enrollment increase is among low-income adults under age 65 (56%), and nearly one-third is among children. According to the KFF estimates, the increase in low-income adults includes 8.9 million (38%) in the Medicaid expansion group and 5.8 million (25%) other adults (mostly low-income parents) who do not qualify for Medicaid based on disability. Estimated enrollment increases have been smaller for adults eligible based on disability or age (1.3 million) and CHIP enrollees (0.2 million). It is expected that the groups that experienced the most growth due to the continuous enrollment provision—ACA expansion adults, other adults, and children—will see the largest enrollment declines.


O’Neil Institute Healthcare Litigation Tracker

The O’Neill Institute for National and Global Health Law launched the Healthcare Litigation Tracker—a free digital resource that tracks and analyzes healthcare litigation in the United States. The website tracker contains current health policy litigation cases, with an emphasis on healthcare access, coverage, affordability, transparency, and equity. The Healthcare Litigation Tracker is designed to be user-friendly and accessible to legal professionals, journalists, and the general public. It is an easy, essential tool for navigating and understanding the role the courts play in shaping U.S. healthcare policy.


Unwinding Home and Community-Based Services PHE Flexibilities is hosting a webinar discussing state requirements and opportunities for resuming Medicaid home and community-based services (HCBS) operations at the end of the public health emergency (PHE). This includes CMS resources to support states in unwinding PHE flexibilities, including considerations for HCBS; an overview of HCBS-related PHE flexibilities to unwind and flexibilities that can be made permanent in 1915(c) waivers and the CMS approval process; and other considerations for HCBS programs when unwinding from the PHE. The webinar will be held March 15, from 2:00 to 3:30 p.m. ET.


State updates: IA, IL, MA, MN, NC, NV, NY, PA, SC & VA

  • Illinois – Governor JB Pritzker joined local, state, and community leaders to announce a new report from the Children’s Behavioral Health Transformation Initiative, which will redesign the delivery of behavioral health services for Illinois youth. The goal of the initiative is to transform statewide systems to provide clear, consistent, and comprehensive guidance to families seeking behavioral or mental health services for children and adolescents.
  • Iowa – The Iowa Department of Health and Human Services (HHS) announced plans to request proposals for the delivery of dental care services for Iowans. HHS is hosting a listening session to solicit feedback on the current dental program and dental contracts that should be considered as HHS develops the new request for proposals.
  • Massachusetts – Governor Laura Healey signed an executive order establishing the Governor’s Advisory Council on Black Empowerment which will advise the governor on issues related to the economic prosperity and well-being of Massachusetts’ Black community, including healthcare, educatio\n, housing, and workforce development.
  • Minnesota – The Minnesota Department of Human Services is awarding $5.7 million to 12 grantees to expand services available to address opioid use disorder. The new investments will address gaps in Minnesota’s continuum of care for Native people and people of color with opioid use disorder who are disproportionately impacted by the opioid epidemic.
  • Nevada
    • Nevada Medicaid is increasing reimbursement rates for doulas from $350 per pregnancy up to $450 to encourage doulas to facilitate access to prenatal/antepartum and oral healthcare. Doulas were first added as an approved provider type in April 2022.
    • The Department of Health and Human Services estimates that approximately 200,000 people will be disenrolled from Medicaid over the course of the unwinding period.
  • New York – New York State of Health, the state’s official health insurance Marketplace, announced its partnership with the state Department of Taxation and Finance to help New Yorkers enroll in quality, affordable health insurance at Taxpayer Assistance Program sites throughout the state. Certified enrollment assisters will meet consumers at participating locations throughout March and into April to compare health plan options, access financial assistance, answer questions and make enrollment appointments.
  • North Carolina – Governor Roy Cooper issued a statement following an announcement of the agreement by state legislative leaders to expand Medicaid.
  • Pennsylvania
    • Pennie, the state’s official health insurance Marketplace, announced nearly 372,000 Pennsylvanians were enrolled in a comprehensive health plan at the conclusion of the state’s open enrollment period. Nearly 65,000 new enrollees joined the Marketplace in 2023, and almost 90% of total customers are receiving financial savings.
    • The Pennsylvania Health Insurance Exchange Authority Board has named Devon Trolley, previously Director of GetCoveredNJ, as the next Executive Director of Pennie. Zachary Sherman, Pennie’s inaugural Executive Director, will be stepping down at the beginning of March after more than three years in the role.
  • South Carolina – The South Carolina Department of Health and Human Services announced a new grant program to increase access to crisis stabilization services for South Carolinians who are experiencing behavioral health episodes, including those associated with mental health and substance use. Through the grant program, the agency will issue approximately $35 million in funds to South Carolina hospitals to build specialized hospital-based emergency departments and observational units dedicated to behavioral health.
  • Virginia – The Department of Medical Assistance Services (DMAS) is hosting seven virtual town hall meetings, in partnership with the Department of Social Services, on upcoming renewals of Medicaid eligibility. The one-hour virtual sessions will cover topics such as background information on the Medicaid unwinding, renewal process plans and partnerships, unwinding communications, outreach and engagement efforts and more.