May 9 Update

In This Week’s Update:

  • New SHVS Resources: NBPP and Family Glitch
  • Text Messaging As A Strategy For The Unwinding
  • The Role of Marketplaces in Mitigating Coverage Loss
  • Medicaid Funding of Community Health Workers in States
  • State Updates: CA, GA, HI, ME, MN, NE, SC, TN & WI

Expert Perspective Examining the Provisions of NBPP Final Rule

Following the release of the final 2023 Notice of Benefit & Payment Parameters, the annual rule governing Affordable Care Act (ACA) marketplaces and insurance reforms, State Health and Value Strategies published an expert perspective examining the provisions of the final rule that are of particular import to state-based marketplaces and state insurance regulators.

Also this week, SHVS published Proposed Regulations Fixing the “Family Glitch” – Considerations for States, an expert perspective that reviews the proposed regulations released by the Treasury Department and the Internal Revenue Service on April 5 and discusses the implications for states. 

Text Messaging as a Strategy for the Unwinding: Opportunity for Public Comment on the Telephone Consumer Protection Act

As state Medicaid and CHIP agencies develop their strategies for unwinding the federal Medicaid continuous coverage requirement, many are looking to text messaging to communicate important coverage information to their enrollees. Some text messages, however, are subject to the Telephone Consumer Protection Act (TCPA), which in many cases requires the sender of a text message to obtain the recipient’s prior consent before sending a text. On May 3, 2022, the Federal Communications Commission (FCC) opened a public comment period for feedback on a letter submitted by the HHS Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure. The letter requests the FCC’s opinion on the use of text messages and automated calls to enrollees as states resume regular operations at the end of the PHE and confirmation that the following entities who deliver text messages and automatic pre-recorded calls will be immune from suit under the TCPA: state and federal government employees; state and federal government contractors when the government agency authorizes and directs the contractor’s actions and the agency validly confers the authorization; local government entities (e.g., agencies of cities and counties) when the state government agency has delegated eligibility authority; andmanaged care entities providing coverage to Medicaid, CHIP or BHP enrollees under contract with a state agency.The 14-day public comment period for feedback will end on May 24. SHVS and our partners at Manatt Health are developing model state comments to inform state letters that we will share with states the week of May 9, 2022.

Mitigating Coverage Loss When the Public Health Emergency Ends: The Role of the Affordable Care Act Marketplaces

As many as 16 million people are expected to lose Medicaid once the COVID-19 public health emergency and the Medicaid continuous coverage requirement end. One-third of these could be eligible for ACA marketplace plans. In a new post for the Commonwealth Fund’s To the Point blog, Sabrina Corlette and Maanasa Kona of the Georgetown Center on Health Insurance Reforms discuss strategies that marketplaces can deploy to help reduce the potential coverage loss and help consumers make a smooth transition. As a reminder, SHVS has a resource page for state officials on the PHE unwinding, which we continually update.

Medicaid Funding of Community Health Workers in States

A growing number of organizations are looking to community health workers (CHWs) as trained and trusted professionals who can bridge gaps between communities and healthcare systems, and work to help reduce inequities. MACPAC recently published an issue brief which surveyed the state landscape in 2021 and found that 21 states provided Medicaid payment for CHW services in their state plan or under managed care arrangements. The brief provides an overview of various types of CHWs and the services they provide, then reviews selected studies documenting the effects of CHW programs on health outcomes and costs, and concludes by describing state approaches to covering CHW services in Medicaid.

State Updates

  • California – As of May 1, Medi-Cal, the state’s Medicaid program, is extending eligibility for full coverage to more than 185,000 individuals who are 50 years of age or older, regardless of immigration status.
  • Georgia – CMS notified Georgia that its previously approved Section 1332 waiver would be suspended but provided the state with the opportunity to submit a corrective action plan that would bring the waiver program into compliance with federal requirements.
  • Hawaii – The University of Hawaiʻi at Mānoa’s Health Policy Initiative (HPI), which aims to improve healthcare in Hawaiʻi, was launched thanks to a $10 million multi-year commitment from the Med-QUEST Division of the state Department of Human Services, the state’s Medicaid program. HPI will facilitate public impact research in health analytics under the direction of the Social Science Research Institute.
  • Maine – Governor Mills signed a supplemental budget that invests $12 million to expand Children’s Health Insurance Program (CHIP) eligibility to children in families with incomes up to 300 percent of the poverty level.
  • Minnesota – The Minnesota Department of Human Services (DHS) announced the launch of a podcast called the LoopBack, a platform for creating dialogue between DHS and community members on topics of community interest, to uplift community voices and explore how DHS can better serve the people of Minnesota. More information about the LoopBack and episode transcripts are available at
  • Nebraska – The Nebraska Department of Health and Human Services (DHHS) launched the first phase of a new benefit application, the iServe Nebraska Portal, that will provide a modern and easy-to-use system for Nebraskans to apply for DHHS benefits and services. The new portal is a single online application for Nebraskans to apply for Medicaid and economic assistance benefits. Those applying for benefits will only need to enter their basic information once.
  • Wisconsin – The Wisconsin Governor’s Health Equity Council (GHEC) released the executive summary and prelude to their full report of final recommendations. Established under Governor Tony Evers’ Executive Order #17, the GHEC was charged with creating a comprehensive plan to achieve long-lasting and equitable health outcomes for all Wisconsinites. The council’s leadership is drafting the full report, to be published in early summer 2022, and is working with council members to finalize recommendations.
  • South Carolina and Tennessee – CMS announced that Tennessee and South Carolina can begin offering Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months postpartum to an estimated 22,000 and 16,000 pregnant and postpartum individuals, respectively, through a new state plan opportunity made available by the American Rescue Plan. Tennessee and South Carolina join Louisiana, Michigan, Virginia, New Jersey, and Illinois in extending Medicaid and CHIP coverage from 60 days to 12 months postpartum.