May 31 Update

In This Week’s Update:

  • Twelve Month Postpartum Expansion News
  • Medicaid: Social Risk Factor Screening Measures
  • Averting Premium Shock in the Marketplace
  • What Racism Costs Everyone
  • State Updates: LA, MN, ND, NJ, NM, NY, OK & OR

Twelve Month Postpartum Expansion

Last week, CMS announced the expansion of Medicaid and CHIP coverage to 12 months postpartum in California, Florida, Kentucky, and Oregon. The expansion of postpartum coverage in these four states will provide coverage to an additional 126,000 families. In California, Kentucky, and Oregon the expansion of coverage to 12 months was made possible by the state plan opportunity included in the American Rescue Plan Act (ARPA), discussed in detail in the issue brief The American Rescue Plan Act’s State Option to Extend Postpartum Coverage. Florida will offer its coverage through a Medicaid and CHIP Section 1115 demonstration.

Averting Premium Shock for Marketplace Consumers

ARPA created enhanced marketplace subsidies that led to record-high marketplace enrollment and significant savings for millions of consumers, but those subsidies are due to expire at the end of this year. More than 13 million people will see substantial premium increases or lose their coverage altogether unless Congress acts to extend enhanced marketplace subsidies created under ARPA. In a new Commonwealth Fund blog post, Georgetown University’s Katie Keith underscores the urgency of the situation. Delayed action, she says, will lead to market turmoil and consumer confusion. If Congress fails to act at all, millions of consumers face premium shock at a time of record-high inflation.

Continuous Eligibility for Children and Adults in Medicaid

Waiver authorities granted through Section 1115 demonstrations are intended to serve the objectives of the Medicaid program and promote access to health coverage. A new blog post from the Georgetown University Center for Children and Families documents a recent uptick in the number of states requesting to expand continuous eligibility through Section 1115 waivers. New Jersey, Oregon, Washington, and New York are all in the process of considering or requesting changes that would expand 12-month continuous eligibility to adults or implement multi-year continuous eligibility. The blog also explains an emerging policy goal–multi-year continuous eligibility for children. Oregon is the first state to formally request CMS approval for it, and Washington is poised to become the second, assuming the provision remains in the state’s waiver application following the state comment period. These waivers present an important opportunity for states to adopt continuous eligibility and strengthen continuity of coverage once the public health emergency ends.

  • Louisiana – The state is requesting to extend its Healthy Louisiana Opioid Use Disorder/Substance Use Disorder (OUD/SUD) Section 1115 demonstration which authorizes the state to provide SUD treatment and withdrawal management services to eligible individuals who are short-term residents in facilities that meet the definition of an institution for mental disease. Through the extension, the state will continue its work to improve its delivery system, expand access to treatment for OUD/SUD including medication-assisted treatment, and to achieve the demonstration milestones.
  • Minnesota – In the most recent LoopBack podcast episode, which profiles the Department of Human Services’ (DHS) community engagement efforts, Commissioner Jodi Harpstead talks about what outreach and engagement work at DHS looks like, why it’s important, and how community members fit into the process. The commissioner shares past and present community engagement efforts and looks ahead to future engagement opportunities with the communities DHS serves.
  • New Jersey – First Lady Tammy Murphy introduced Connecting NJ, New Jersey’s network of partners and agencies dedicated to helping New Jersey families thrive. The website centralizes information and referrals to state and local wellness services, including healthcare for mothers and children, early education programs, domestic violence support, addiction treatment, financial and housing assistance, home visiting programs, behavioral health services, and more. As a single point of entry for community members in need, Connecting NJ simplifies the process of accessing care.
  • New Mexico – Families of almost 40,000 New Mexico school-aged students grade level K through 12 will receive benefits on May 22, 2022, to reimburse them for free and reduced-price school meals missed due to COVID-related absences. Approximately $2,384,826 in Pandemic Electronic Benefit Transfer will be issued to cover meals K-12 students missed in December 2021 and January 2022, after schools returned to in-person learning. The issuance amount is $7.10 per day the child was absent from school due to COVID.
  • New York – New York State Department of Health announced children 5- to 11-years old should receive a COVID-19 vaccine booster five months after completing their initial two-dose Pfizer-BioNTech vaccine series. Booster doses for children are free and widely available statewide, including at over 2,000 locations administering the vaccine for children and the state’s mass vaccination sites.
  • North Dakota – The North Dakota Department of Health announced the release of the North Dakota Alzheimer’s and Dementia Data Dashboard, a new web-based dashboard created in support of the 2022 North Dakota Alzheimer’s and Dementia State Plan. North Dakota reports the fourth highest mortality rate for Alzheimer’s disease in the United States at 52.9 per 100,000 North Dakota residents. The rate for the U.S. is 37 per 100,000 residents.
  • Oklahoma – The Oklahoma Health Care Authority announced it will transition to a new health care model following Governor J. Kevin Stitt’s signing of two delivery reform bills. SB 1337 codifies the system design for a transformed Medicaid program and creates preferential opportunities for Oklahoma provider led entities to partner with OHCA as contracted entities. Under the law, contracted entities can include accountable care organizations, provider-led entities, commercial plans and/or dental benefit managers. OHCA is required to choose at least three contracted entities for medical services, two contracted entities for dental services, and one contracted entity for the children’s specialty plan. Implementation begins October 1, 2023. SB 1396 makes avaliable additional funding for the Oklahoma health care community by drawing down additional federal dollars in the form of supplemental payments to qualifying providers.
  • Oregon – State health officials at the Oregon Health Authority announced a plan to distribute a package of $517 million in investments aimed at improving behavioral health services in Oregon. This includes $132 million which will flow to treatment providers starting this week. The investments will be used to bolster the behavioral health workforce and expand treatment services. The state also will distribute funds to provide housing and other support services to people with mental health and substance use issues.