March 7 Update

In This Week’s Update:

  • Virginia Invests in Doulas to Improve Maternal Health Outcomes
  • End of PHE eligibility and enrollment toolkit
  • Medicaid enrollment trends during COVID_19
  • New SHVS issue brief: messaging public charge
  • TA opportunity: easy-to-use digital tools and services
  • State updates: AK, MD, MN, NV, NY, OR & PA

Virginia Invests in Doulas to Improve Maternal Health Outcomes

The United States is facing a maternal health crisis, as maternal mortality rates continue to rise with significant racial, ethnic, and socioeconomic disparities in birth outcomes. Nationally, there has been a growing interest in expanding the maternal health workforce with an investment in doulas–trained professionals who provide continuous physical, emotional, and informational support to pregnant people before, during, and shortly after childbirth. In January 2022, Virginia became the latest state to cover doula services through its Medicaid program. The National Academy for State Health Policy released a new blog post detailing Virginia’s doula benefits, including their reimbursement structure. Community doulas can begin enrolling in the state’s Medicaid program this spring.

Options for states to align work on pending eligibility and enrollment actions after the PHE ends

CMS released a State Health Official letter outlining guidance to ensure states are well-prepared to initiate eligibility renewals for all individuals enrolled in Medicaid and CHIP within 12 months of the eventual end of the PHE and to complete renewals within 14 months. The new guidance provides reporting tools as well as an eligibility and enrollment tool. State Health and Value Strategies’ experts are digging into the guidance and evaluating what additional programming will be most helpful to states. SHVS has a resource page dedicated to unwinding the continuous coverage requirement with a range of resources, from an issue brief on creating a dashboard to track enrollment during unwinding, to a communications toolkit.

Medicaid Enrollment Trends During COVID-19

CMS released the latest enrollment figures for Medicaid, and CHIP. To help states better understand the enrollment trends during the COVID-19 pandemic, SHVS has updated our Databook 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. The key trends observed in this updated version of the Databook are the subject of a new SHVS issue brief out today, Medicaid Enrollment Trends During the COVID-19 Pandemic

New SHVS Issue Brief: Reshaping the Narrative on Public Charge to Reach Immigrant Populations

Many immigrants and their families are concerned that enrolling in Medicaid/CHIP, Marketplace, and other public health insurance programs will run afoul of public charge rules and jeopardize their immigration status. These fears remain despite the fact that the administration has reinstated longstanding public charge guidance that does not consider the use of Medicaid/CHIP benefits (other than government-funded institutionalization for long-term care) or Marketplace coverage in a public charge determination. This latest issue brief in SHVS’ series, Supporting Health Equity and Affordable Health Coverage for Immigrant Populations, provides an overview of the status of the public charge rule and presents strategies to help connect eligible individuals to affordable coverage.

Code for America Intiative to Work with State Governments to Support Equitable, Easy-To-Use Digital Tools and Services

Code for America (CFA) has received philanthropic funding to engage with and deepen partnerships in 15 states over the next 7 years. CFA will partner with states in groups of three “cohorts,” or roughly five states per cohort, with the first one kicking off this spring. CFA will work with each state for two to three years to build a more human-centered safety net, removing barriers to public benefit enrollment, usage, and retention. States will partner with CFA on an initial discovery phase to identify priority areas for change across SNAP, WIC, and integrated benefits, and then implement concrete changes in an agile, iterative manner in partnership with CFA over the subsequent 12 to 18 months. The partnership will focus on enabling states to maintain the changes over the long-term, with a final six to nine month handoff phase focused on solidifying state capacity. States will also participate in a quarterly cohort convening led by CFA to connect with their peers and share resources as they go on this shared journey. Representatives from interested state governments can sign up to receive additional information as it becomes available including a soon-to-be-released request for information.

  • Arkansas – The Arkansas Department of Human Services announced a workforce stabilization incentive program for Home and Community-Based Services (HCBS) providers through which roughly $112 million is available to help providers with retention and recruitment efforts. The program is the first phase of the state’s plan for the funding available for HCBS through the American Rescue Plan Act.
  • Maryland – Governor Larry Hogan announced that a record number of Marylanders enrolled for health coverage through Maryland Health Connection, the state’s official health insurance marketplace, during the recently ended open enrollment period. The 182,861 enrollments marked a 10 percent increase over the 2021 open enrollment total of 166,038.
  • Minnesota
    • The Department of Human Services (MNDHS) released a request for proposals (RFP) as it is seeking to provide integrated, culturally supportive perinatal care to American Indian people at high risk for low-birth weight and preterm births.
    • MNDHS has also released an RFP to provide supportive services for people with Serious Mental Illness (SMI) who are homeless or exiting institutions who have complex needs and face high barriers to obtaining and maintaining housing. Services provided will assist people to transition to and sustain permanent supportive housing and proposals must also address one or more of the behavioral health priorities of program linkage, peer services, veterans, and equity.
  • Nevada 
    • The Silver State Health Insurance Exchange, the state agency that operates the online marketplace known as Nevada Health Link, announced Ryan High as its new executive director. Ryan joined the Exchange as the Chief Operations Officer in October of 2016. Congratulations, Ryan!
    • Governor Steve Sisolak announced that Nevada will be joining the Northwest Prescription Drug Consortium, operated by Oregon and Washington, to reduce prescription drug costs for enrolled Nevadans. The Nevada Department of Health and Human Services is coordinating with the Consortium to implement the program, which will allow a consumer to save on average up to 80 percent on generic drugs and up to 20 percent on brand name drugs. It is free to enroll and available to all residents of Nevada, whether they hold private insurance, are underinsured, or are uninsured.
  • New York
    • NY State of Health, the state’s official health insurance marketplace, released fact sheets that show the impact of American Rescue Plan Act (ARPA) enhanced tax credit savings and PHE easements by New York Congressional District. The ARPA savings are key to a smooth transition into affordable coverage for individuals who may no longer be eligible for Medicaid or the Essential Plan following resumption of regular renewal processes at the end of the PHE.
    • NY State of Health announced plans to provide free, onsite enrollment assistance to job seekers across the state. NY State of Health certified enrollment assisters will be available at more than 12 in-person job fairs throughout the spring to answer questions about health coverage available through the Marketplace and to schedule appointments to enroll.
  • Oregon – The Oregon Health Authority (OHA) announced the launch of the new Health Care Market Oversight (HCMO) program, which was established by HB 2362 in the 2021 Legislative Session. This law directs OHA to review business deals that consolidate the health system in a way that could impacts, costs, quality, access and equity for Oregonians. As of the launch on March 1, large healthcare entities such as hospitals, health insurance companies, and provider groups proposing to merge or acquire other entities must file notice with the HCMO program. The review process also allows for the community to understand the potential impacts of a transaction and weigh in.
  • Pennsylvania – Governor Tom Wolf announced that Pennsylvania’s state-based health insurance marketplace, known as Pennie, has added a new qualifying life event to allow Pennsylvanians with an annual household income equal to or below 150 percent of the federal poverty level the ability to enroll in health insurance throughout the year.