May 23 Update

In This Week’s Update:

  • PHE News
  • New tool: ARPA Funding for Communities
  • Healthcare Costs in the Absence of ARPA
  • School-based behavioral health services
  • State Updates: CA, CO, GA, MA, MI, MN, NH, TX, VA & WA

End of Public Health Emergency: Update

Monday, May 16 marked the deadline for HHS to provide 60 days’ notice prior to termination of the federal PHE and the day passed without notice. HHS has reiterated its commitment to providing states with 60 days’ notice, and as such, it is expected that the PHE will be renewed at least once more. The PHE is currently in effect through July 14 (per the April 12 renewal notice, which began on April 16 and applies for 90 days). For more information about specific end dates related to the PHE, SHVS has a chart that summarizes the timeframes for the emergency measures currently in place, including the effective dates and expiration timelines dictated by law or agency guidance.

As a reminder, SHVS has a resource page that is an accessible one-stop source of information for states on “unwinding” when the Medicaid continuous coverage requirement ends. 

New Tool Breaks Down ARPA Funding for Communities

The Georgia Health Policy developed an interactive tool, Funding Resilience: Advancing Multisector Investments for Equity, designed to help communities 1) envision how COVID-19 relief and recovery funds might be used for cross-sector initiatives aimed at building equitable, healthy communities and 2) understand scope of funds available to states to meet a wide variety of needs. Real-time, interactive features of the tool include: breakdowns of American Rescue Plan Act funds by social determinant of health; a detailed overview of the investment opportunities by federal department; state snapshots of verified funds; state and local fiscal recovery funds; notice of current funding opportunities.

School-Based Behavioral Health Services in K-12 Schools

Defining and meeting the needs of schools to support youth behavioral health is particularly important given the current youth behavioral health crisis. Behavioral health challenges in children were rising even prior to the COVID-19 pandemic, and youth psychological distress and unmet behavioral health need increased further during the pandemic. The increased behavioral health challenges among youth translate to more children needing services in school, and states are working to respond to this challenge and potential opportunity. A recently published white paper by the Children’s Hospital of Philadelphia PolicyLab describes several innovative strategies implemented by states and municipalities in support of comprehensive behavioral health services in schools.

Healthcare Costs in the Absence of ARPA

A new issue brief by Families USA analyzes CMS estimates of average premium costs paid per person, with and without ARPA, for states. ARPA has reduced families’ premium costs by increasing the advance premium tax credits that people use to buy insurance in health insurance marketplaces. Unless Congress acts to extend ARPA support, which is currently set to expire on January 1, 2023, the CMS estimates project that premiums will increase by 53 percent on average. The issue brief also provides a ranked list of the top 20 states projected to experience an increase in premium costs per person buying insurance from if ARPA is not extended.

State Updates

  • California –  The Department of Health Care Services (DHCS) released the Medi-Cal COVID-19 Public Health Emergency Operational Unwinding Plan. The two primary purposes of this document are to: 1) describe DHCS’ approach to unwinding or making permanent temporarily flexibilities implemented across the Medi-Cal program during the PHE; and 2) describe DHCS’ approach to resuming normal Medi-Cal eligibility operations following the end of the PHE.
  • Colorado – Governor Polis signed several health-related laws, including bills to help primary care physicians better meet the behavioral health needs of Coloradans (HB22-1302); cut costs for people seeking affordable and accessible preventive care from family doctors in their communities (HB22-1325); save employers and Colorado patients money on prescription drugs (HB22-1370); support community-based programs that improve behavioral health outcomes for children, youth, and families across the state (HB22-1281); and expand access to inpatient and residential treatment options for Coloradans seeking behavioral healthcare (HB22-1303).
  • Georgia – Governor Brian Kemp signed into law the state’s fiscal year 2023 budget bill which includes funding for the expansion of Medicaid post-partum coverage to 12 months.
  • Massachusetts – Massachusetts Health Connector, the state’s official health insurance marketplace, posted a request for responses (RFR) that seeks responses from entities that could conduct an audit of administrative burdens felt by Health Connector members or potential applicants for Health Connector coverage. The Health Connector is particularly interested in applying an equity lens to this exploration in an effort to understand how present administrative burdens may or may not disproportionately affect applicants and members from communities of color, immigrant populations, LGBTQ+ populations, those with limited English proficiency, those with disabilities, and/or other populations that may face historical or structural barriers. Responses to the RFR are due on July 15.
  • Michigan – Governor Gretchen Whitmer announced that the Healthy Michigan Plan, the state’s Medicaid program, is providing healthcare coverage to 1,000,456 Michiganders, marking the first time more than one million people have been enrolled under the program.
  • Minnesota – The Department of Human Services (DHS), through its Grants, Equity, Access, and Research Division, is seeking Home and Community-Based Service (HCBS) providers or organizations interested in becoming HCBS providers to support older adults and people with disabilities. DHS is providing grants to increase the number and ability of HCBS service providers in rural and underserved communities.
  • New Hampshire – In a press release, New Hampshire highlighted that a recent study by the Urban Institute and the Robert Wood Johnson Foundation shows that ACA benchmark premium rates in New Hampshire are the lowest in the country. Benchmark premiums in New Hampshire have decreased for the second year in a row, down from $405 per month in 2020, to $333 per month in 2021 and $309 per month in 2022. New Hampshire enjoyed the fifth-largest reduction in ACA benchmark premium rates, 8.2 percent, from 2019 to 2022. The national average over that time period was a 2.2 percent reduction.
  • Texas – The state submitted an amendment to the Texas Healthcare Transformation and Quality Improvement Program section 1115(a) demonstration to CMS. The state is proposing to deliver the Case Management for Children and Pregnant Women (CPW) Medicaid benefit via the managed care delivery system. CPW, which provides case management services to assist certain individuals in gaining access to needed medical, social, educational, and other services, is currently provided fee-for-service.
  • Virginia – The U.S. Department of Health and Human Services and the Department of the Treasury approved Virginia’s application for its Section 1332 waiver for a reinsurance program, which will reimburse certain insurers for high-cost claims. The approval is effective for January 1, 2023 through December 31, 2027.
  • Washington – The Health Care Authority (HCA) announced that HCA Director Sue Birch has selected Dr. Charissa Fotinos as the new state Medicaid director. Dr. Fotinos has been the interim state Medicaid director since August 2021 and will also continue to serve as HCA behavioral health medical director, the position she held previously. Congratulations Charissa!