May 15 Update

In This Week’s Update:

  • End of the Public Health Emergency
  • Sequencing Communications to Encourage Coverage Transitions
  • A Closer Look at Medicaid Call Center Options as the Unwinding Kicks Into High Gear
  • State updates: AR, CO, IA, IN, MA, MI, MN, MO, NJ, NV, OR, PA, RI, VT & WA


End of the Public Health Emergency

May 11 marked the end of the federal public health emergency (PHE). While the end of the COVID-19 PHE does not impact Medicaid unwinding, there are implications for temporary Medicaid and CHIP flexibilities tied to the PHE, and State Health and Value Strategies (SHVS) has updated their resource, Federal Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts Effective and End Dates, which summarizes the timeframes for these emergency measures, including the effective dates and expiration timelines.


Also last week, Heather Howard at SHVS released a new episode of her podcast, the Princeton Pulse, which features Kate McEvoy, Executive Director of the National Association of Medicaid Directors, and Dr. Kemi Alli, a pediatrician and CEO of Henry J. Austin Health Center, a federally qualified health center in Trenton, New Jersey. They discuss strategies for maximizing continuity of coverage for consumers—along with who is most likely to slip through the cracks and the role of state health officials and healthcare providers. And in case you missed it, Dr. Richard Besser, RWJF President and CEO, co-authored an op-ed highlighting that 5 million children are at risk of losing coverage as a result of the unwinding. In the op-ed, Dr. Besser encourages governors to take measures to ensure eligible children maintain their coverage.


Sequencing Communications to Encourage Coverage Transitions

As a result of the Medicaid renewal process, which resumed in April 2023, it is expected that millions of people across the country will lose Medicaid and in some cases, CHIP coverage. This presents State-Based Marketplaces (SBMs) with an opportunity to target outreach efforts to those audiences who have recently lost Medicaid or CHIP to help eligible individuals retain access to affordable healthcare through the Marketplace. This new expert perspective focuses on best practices for timing and strategy in consumer outreach to consumers that are no longer eligible for Medicaid to help states develop a consumer “chase campaign” and is a follow-up to an earlier expert perspective, State Strategies for Sequencing Enrollee Communications When Medicaid Continuous Coverage Ends, which focused on communications to consumers when unwinding began.


A Closer Look at Medicaid Call Center Options as the Unwinding Kicks Into High Gear

Automated phone systems, when well designed, can efficiently provide information or direct callers to a person who can help. But if a phone tree has too many options or tries to convey too much information, it makes it difficult for people to get the help they need. A new blog post from the Georgetown University Center for Children and Families details the findings from two rounds of calls to state Medicaid call centers to see what consumers encounter when they call the hotline. Specifically, the authors wanted to know if the call center offers a call back option; prompts for non-English speakers; a separate dial option to update contact information; or reports the approximate wait time or the caller’s place in a queue. The blog post features a map to see which of the four key call center features each state has implemented as they unwind the Medicaid continuous coverage requirement.


State updates: AR, CO, IA, IN, MA, MI, MN, MO, NJ, NV, OR, PA, RI, VT & WA 

  • Arkansas – The Arkansas Department of Human Services reported figures reflecting the first month of redeterminations as part of its six-month Medicaid unwinding effort. The total number of disenrollments in April was 72,802.
  • Colorado
    • Governor Jared Polis signed HB23-1201, which will eliminate the practice of “spread pricing,” or up-charging of prescription drugs by middlemen on insured individual and group policies. It also creates an opt-in provision so that self-insured employers can benefit from this affordability law as well. The bill also adds a spread pricing prohibition for Health First Colorado (Colorado’s Medicaid program).
    • Governor Polis also signed HB23-1243 into law, which builds upon existing legislation to further increase nonprofit, tax-exempt hospitals’ transparency and accountability to their communities. The legislation increases transparency by requiring more detailed reporting on how and where community benefit dollars are invested and how that relates to community voice.
  • Indiana – The Indiana Family and Social Services Administration (FSSA) announced the completion of the rollout of My Healthy Baby, the state’s obstetrical navigator program that is designed to improve health outcomes for both mother and baby. Launched in 2020, My Healthy Baby is a partnership between FSSA, the Department of Health and the Department of Child Services that connects pregnant individuals who are enrolled in Medicaid with free home visiting services and support in their communities during their pregnancy and throughout their baby’s first year of life.
  • Iowa – The Iowa Department of Health and Human Services announced that the Bureau of Refugee Services has awarded contracts totaling $3.1 million for wraparound supports for refugees in Iowa. The list of successful bidders includes 20 community and faith-based organizations that submitted proposals for this work in Iowa. The proposals selected for award address four broad categories of services and supports, including community integration services; services to older refugees; youth refugee services and supports; and startup services to help build their organization to better meet the needs of refugees in Iowa.
  • Massachusetts – MassHealth (Medicaid) and the Massachusetts Health Connector, the state’s official health insurance Marketplace, are presenting a webinar “MassHealth Renewals and Available Resources for Massachusetts Employers” on May 17, 2023. The session will cover the MassHealth renewal process and health coverage options through the Marketplace for those employees who may not be eligible for employer benefits. A toolkit is also available to promote the webinar.
  • Michigan – Governor Gretchen Whitmer issued an executive directive instructing all state of Michigan departments to work together to help Michiganders keep Medicaid coverage or find affordable health insurance as Medicaid renewals begin. The executive directive instructs all state departments to assist the Department of Health and Human Services (DHHS) and the Department of Insurance and Financial Services (DIFS), by distributing information to Michiganders regarding the redetermination process and how to renew eligibility, and sharing necessary data to conduct outreach. Additionally, both DHHS and DIFS have created websites dedicated to unwinding.
  • Minnesota – MNsure, the state’s official health insurance Marketplace, is offering a special enrolment period (SEP) for Minnesotans who are currently enrolled in unaffordable family health insurance through an employer with a renewal date other than January 1. Families can determine whether their coverage is unaffordable using MNsure’s Employer Insurance Affordability Estimator. The SEP is open through October 31, 2023.
  • Missouri – The Missouri Family Support Division (FSD) launched a new FSD Benefit Portal to help Missourians access important updates about their benefits and submit information to FSD. Medicaid enrollees can use the portal to find when their Medicaid annual renewal is due and submit their renewal form as well as view a notice to alert them that FSD successfully completed their annual renewal. FSD will also send information about annual renewals, including a yellow annual renewal form to participants by mail.
  • Nevada – The Nevada Division of Health Care Financing and Policy announced that Nevada Medicaid has expanded access to dental care for adults with certain disabilities. Newly available services include root canals; preventative care; multiple doctors’ appointments; fillings; cleaning; and sedation. People who qualify can receive up to $2,500 in benefits per year. To help families, caregivers, and dentists learn about the new dental benefits, Nevada Medicaid has started the Every Smile Matters Nevada website.
  • New Jersey – The New Jersey Department of Banking and Insurance Commissioner Marlene Caride announced the creation of an extended special enrollment period (SEP) for individuals who are no longer eligible for NJ FamilyCare (Medicaid) and qualify for health insurance through Get Covered New Jersey, the state’s official health insurance Marketplace. The department has established an extended SEP to allow these individuals 120 days to sign up for coverage and provides flexibilities that create a streamlined transition between the programs, offering consumers the option of having an earlier effective date of coverage to avoid coverage gaps.
  • Oregon – The Oregon Health Authority released its first report on cost growth trends for health insurance plans and large provider organizations across the state. The report provides insight into healthcare spending growth across the commercial, Medicaid and Medicare markets for 29 payers and 51 provider organizations. Payers and provider organizations were more likely to meet the cost growth target for their Medicaid line of business (and Medicaid patients) compared to commercial and Medicare Advantage. Overall, healthcare costs grew 3.5% between 2020 and 2021, just above the cost growth target of 3.4%. Cost growth was primarily due to increased utilization of healthcare services as people resumed care they may have postponed in the first part of the COVID-19 pandemic.
  • Pennsylvania – The Pennsylvania Department of Human Services (DHS) and Pennie (the state’s official health insurance Marketplace) announced a collaborative multichannel, long-term outreach strategy to raise awareness of the critical need for Pennsylvanians to complete their Medicaid and CHIP renewals on time when it is their turn to maintain healthcare coverage. Advertisements span English and Spanish-language television and radio, video and music streaming platforms, social media channels, public transit systems, and billboard placements around the Commonwealth.
  • Rhode Island – The Office of the Health Insurance Commissioner released new data that shows healthcare spending in Rhode Island rebounded in 2021 after pandemic-driven declines. The data show that healthcare spending increased most significantly in the commercial market (9.7%) followed by Medicare (8.0%) during 2021 after a 2.9% decline in overall spending per person the year prior, and on average, healthcare spending increased from $7,887 to $8,262 per person in the state.
  • Vermont – Governor Phil Scott signed abortion and gender-affirming shield bills into law that protect access to medication used in abortions, even if the U.S. Food and Drug Administration withdraws approval of the pill, Mifepristone. The bills also protect providers from discipline for providing legally protected reproductive and gender-affirming healthcare services.
  • Washington – The Office of the Insurance Commissioner issued a press release, “Learn What’s Covered After the COVID-19 Emergency Ends,” describing changes to health insurance coverage of COVID-19 related services such as vaccines, COVID-19 tests, treatment, and telemedicine.