May 11 Update

In This Week’s Update:

  • SHVS Resources on Health Equity and COVID-19
  • State Updates: AZ, CO, DE, LA, ME, MI, NC, NE, NM, NY, OH, OR, TX & WV
  • Webinar: COVID-19 and Coverage Options
  • Impact of COVID-19 Pandemic on Hispanic Adults
  • COVID-19 Recession and Health Insurance Coverage
  • Maternal Health and COVID-19
  • Rural Health and COVID-19

 

SHVS Resources on Health Equity and COVID-19

As the COVID-19 crisis evolves, it has become increasingly clear that vulnerable populations are disproportionately impacted. Last week, State Health and Value Strategies hosted a webinar, Health Equity and COVID-19: Tracking and Taking Action to Address Disparities, which covered how states are tracking the disproportionate impact of the disease on vulnerable populations and also provided a framework for states to begin examining their COVID-19 response efforts to yield better outcomes for such populations. If you missed the webinar, SHVS posted the slides and a recording on its website. As a companion to the webinar, SHVS also published a new expert perspective authored by Health Equity Solutions on the Five Key Questions State Health Officials Can Ask Right Now to Advance Health Equity During COVID-19 Response Efforts. Asking these series of core questions and immediately responding with appropriate action can strengthen initial responses and lay the foundation for broader reforms to advance health equity.

SHVS has also published a revised version of the expert perspective States’ Reporting of COVID-19 Health Equity Data to account for the latest updates in states’ dashboards and reporting. SHVS will continue to track state reporting and will be updating this expert perspective on a weekly basis.

 

State Updates

  • Addressing Social Risk Factors
    • Delaware – The Division of Social Services was approved by the United States Department of Agriculture to operate Pandemic Electronic Benefit Transfer (P-EBT), a new program authorized by the Families First Coronavirus Response Act that provides assistance to families with children who are eligible for free or reduced-price school meals.
    • New Mexico – New Mexico families will receive more than $97 million in additional food benefits, enough to feed about 245,000 children, following federal approval of a Pandemic Electronic Benefit Transfer Program. The New Mexico Human Services Department and the Public Education Department submitted the request jointly to the U.S. Department of Agriculture.
  • Bulletins and Notices to Providers
  • State Recovery and Reopening Plans
    • Louisiana – The Louisiana State Fire Marshal’s Office, under the direction of Governor John Bel Edwards and in collaboration with the Louisiana Department of Health, has activated a new, web-based program to assist businesses and religious organizations with safely resuming operations as the public health emergency due to COVID-19 continues. OpenSafely.la.gov allows business owners and church leaders to register in order to receive information on what phase their business and/or church is considered, what phase the state is in as Louisiana moves through phases of return and what social distancing and sanitation guidelines are required for their specific operation in each phase. 
    • Maine – Governor Janet Mills announced that she is convening an Economic Recovery Committee. The thirty-seven member Committee includes representatives of small businesses, nonprofits, financial institutions, unions, municipalities, tribal and immigrant communities, hospitality and tourism industries, and educational institutions, as well as a bipartisan delegation of legislative designees.
  • Testing
    • Arizona – AHCCCS is directing providers to seek reimbursement for COVID-19 testing and treatment of uninsured Arizonans through the federal HRSA web portal. AHCCCS had received federal approval and was working on a separate eligibility category to cover the cost of COVID-19 testing for uninsured individuals in Arizona. Following the announcement of the federal portal, as well as the added benefit of payment for treatment, AHCCCS is suspending that effort.
    • West Virginia – Governor Jim Justice announced that an effort to test all residents and staff members at every assisted living facility in West Virginia is underway. The action came after the Governor’s Executive Order made West Virginia the first state in the nation to require all-inclusive assisted living facility testing statewide.
  • Other
    • Colorado
      • United States Senators Michael Bennet (D-CO) and Cory Gardner (R-CO) wrote Congressional leadership requesting an additional round of Medicaid FMAP enhancement in the next COVID-19 legislative package to provide states with expeditious fiscal relief. The Senators call for this enhancement to bring the total FMAP enhancement for Medicaid up to 12 percentage points.
      • In order to reduce the spread of illness and number of deaths in nursing homes and assisted living facilities, the Colorado Unified Command Center (UCC) has launched a Residential Care Task Force.
    • Michigan – Governor Gretchen Whitmer signed Executive Directive 2020-5, creating the Michigan COVID-19 Office of Accountability within the State Budget Office. The Accountability Office will provide oversight of all spending to address this crisis, and must report regularly on its work to the governor and the state budget director. 
    • New York – Governor Andrew M. Cuomo announced that 35 counties have been approved to resume elective outpatient treatments. The Governor previously announced that the state will allow elective outpatient treatments to resume in counties and hospitals without significant risk of COVID-19 surge in the near term.
    • Ohio – Due to the economic impact of COVID-19, Governor DeWine announced $775 million in reductions to Ohio’s General Revenue Fund for the remainder of Fiscal Year 2020, which ends on June 30. Because Ohio is mandated to balance its budget each year, DeWine announced, in addition to identifying areas of savings, budget reductions to be made for the next two months, which include a reduction of $210 million to Medicaid.

Other State Updates

  • Nebraska – The Nebraska Department of Health and Human Services will hold a public hearing via conference call on Monday, May 18 to receive additional comments on proposed changes to regulations that govern hospital services under Nebraska’s Medicaid program. The proposed changes include a new process for public comments and a public hearing before any new rate methodology is made effective. 
  • Oregon – The Oregon Health Authority released the schedule for 2020-2024 State Health Improvement Plan (SHIP) subcommittee meetings. Oregon’s SHIP identifies interventions and strategies to address health-related priorities in the state and serves as a basis for taking collective action with cross-sector partners to improve the health of people in Oregon. The subcommittees are tasked with identifying strategies and measures and developing work plans for implementing the SHIP. All meetings are virtual and open to the public.
  • Texas – Texas Health and Human Services Executive Commissioner Phil Wilson announced that Stephanie Stephens will head the state’s Medicaid/CHIP Services division. She previously served as HHSC’s deputy state Medicaid director.

 

Webinar: Changes in Coverage: Managing the Loss of ESI in the Midst of COVID-19

Thursday, May 14, 2020, 3:00 to 4:00 p.m. EST

As the COVID-19 crisis evolves, it has become clear that rising unemployment will substantially reduce employer-sponsored health insurance. Depending on how Congress responds, there are likely to be significant increases in Medicaid and Marketplace coverage, as well as more people uninsured. These coverage changes will leave states grappling to understand and implement timely and effective strategies to ensure individuals have access to, and enroll in, coverage that is most appropriate for their situation. State Health and Value Strategies, in partnership with technical experts, is hosting a webinar for states to help address the rapidly-evolving changes to the coverage environment. During the webinar, speakers will discuss the models that have been published of where individuals are expected to gain coverage over the next 18 months, the impact on the Medicaid, individual, and employer-sponsored insurance markets, the role of special enrollment periods, and coordination with unemployment agencies. The webinar will also highlight communications opportunities and strategies for states to support enrollment.

Registration (required) at the following link:  https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=efaf9f91b7cd8033d33ef2df54b4c28fa

 

Hispanic Adults in Families with Noncitizens Disproportionately Feel the Economic Fallout from COVID-19

Supported by the Robert Wood Johnson Foundation, a report by the Urban Institute examines the impact of the COVID-19 pandemic on Hispanic adults’ family financial security. The analysis finds that Hispanic adults in families with noncitizens are disproportionately represented in industries affected by the outbreak and therefore experience more negative unemployment impacts than families with no noncitizens. In addition to experiencing loss of jobs and earnings at high rates during the pandemic, many of these adults are barred from federal relief efforts and safety net programs or have been discouraged from applying for assistance because they fear it may adversely affect their or their family member’s immigration status. This brief focuses on the impact of the COVID-19 pandemic on family employment, financial security, and material hardship among nonelderly Hispanic adults by family citizenship status, drawing on data from the Urban Institute’s Health Reform Monitoring Survey.

 

How the COVID-19 Recession Could Affect Health Insurance Coverage

A new analysis by the Urban Institute supported by the Robert Wood Johnson Foundation estimates how health insurance coverage could change as millions of workers lose their jobs during the COVID-19 recession. The authors present national and state-level estimates of coverage changes if unemployment rates rise from pre-crisis levels (around 3.5 percent nationally) to 15 percent, 20 percent, or 25 percent. For each unemployment level, the authors provide a base case scenario of coverage changes and a high scenario, respectively derived from two different estimation methods. The analysis estimates that at 20 percent unemployment, approximately 25 million people will lose ESI coverage, and of them, 12 million would gain Medicaid coverage, six million would gain Marketplace or other private coverage, and seven million would become uninsured.

 

Improving Maternal Health Access, Coverage, and Outcomes in Medicaid

The pandemic has elevated the urgency to provide access and coverage to maternal models that are safe for the Medicaid population. Based on the decades of data demonstrating that the midwifery-led model of care is an evidence-based, high-value option, the Institute for Medicaid Innovation developed a report that provides information to support the development of a business case for the midwifery-led model of care in Medicaid and discusses the realities and challenges this model may face. The resource also highlights case studies with lessons learned as well as a check list for essential items to consider.

 

Rural Health and COVID-19

Delivering health care in rural communities presents unique challenges that have always required coordination and innovation. In the midst of the COVID-19 pandemic, it is essential that rural communities and health care providers have access to the resources they need to combat the virus. On Tuesday, May 12, HHS and the USDA are hosting a webinar that will provide an overview of the rural health-focused efforts by the agencies and highlight specific tools and resources to help combat COVID-19.