November 12 Update: Elections Impact; Public Charge FAQs; Safety Net Programs Reduce Hardship

Last week, on the state-level, three states approved expanding their Medicaid programs and the results of several gubernatorial elections signal potential changes in state health policy. For a synopsis of what the election results mean for health care, see this Health Affairs blog post. In addition, the Kaiser Health News podcast What the Health? includes an analysis of midterm election results (starts at 6:42).

Also last week, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule related to program integrity of Exchange operations. This Health Affairs blog post summarizes this rule, including implications for states. CMS also announced a proposed rule for Medicaid and Children’s Health Insurance Program (CHIP) managed care programs. CMS released a fact sheet explaining the goals of this proposed rule. Updates follow.

State updates: AZ, FL, MN, NJ, NH, NY, & WV

  • Arizona – Governor Doug Ducey announced that Tom Betlach, director of the Arizona Health Care Cost Containment System, will retire in January 2019, after 27 years of service to the state of Arizona. Betlach led Arizona’s Medicaid agency for the past nine years and served as its deputy director for the prior eight years.
  • Florida – The Agency for Health Care Administration released a Frequently Asked Questions document about the transition to new Statewide Medicaid Managed Care plans. The state will be rolling out transitions to the new plans beginning December 1 through February 1, 2019.
  • Minnesota – MNsure, the state’s official health insurance marketplace, issued an update on the first week of open enrollment reporting low wait times and a steady stream of visitors signing up for health coverage. Open enrollment figures will be released this Wednesday at the MNsure public board meeting.
  • New Jersey
    • The New Jersey Housing and Mortgage Finance Agency (NJHMFA) invited hospitals statewide to participate in a $12 million partnership program promoting investment in affordable and supportive housing in their communities. Under the Hospital Partnership Subsidy Pilot Program, NJHMFA will match funding contributions from participating hospitals to provide housing for low- and moderate-income families.
    • The New Jersey Department of Human Services is providing $375,000 in funding and support to five community organizations that will help enroll New Jersey residents in health coverage. The initiative is part of Governor Phil Murphy’s effort to enroll more New Jerseyans during the Affordable Care Act’s (ACA) open enrollment period
  • New Hampshire – The state submitted a request to CMS to amend its Building Capacity for Transformation section 1115(a) demonstration. The goal of the amendment is to substitute three Designated State Health Programs in the Special Terms and Conditions. The federal public comment period is open through December 6, 2018.
  • New York – NY State of Health, the state’s official health plan marketplace, announced it is again partnering during the open enrollment with ridesharing companies Lyft and Uber, and with the Independent Drivers Guild. Through the partnership, tens of thousands of drivers throughout the state will be urged to visit the marketplace to shop for and enroll in health insurance.
  • West Virginia – Department of Health and Human Resources Cabinet Secretary Bill J. Crouch appointed Catherine C. Slemp, MD, MPH, as Interim State Health Officer and Commissioner of DHHR’s Bureau for Public Health. Dr. Slemp replaces Dr. Rahul Gupta who announced his resignation September 18, 2018.

Upcoming Webinar – Save the Date!

The SUPPORT Act: New Tools for States to Address the Opioid Epidemic

Friday, November 16, 2018 12:00 to 1:00 p.m. ET

State Health and Value Strategies (SHVS) will host a webinar, with technical experts from Manatt Health, on H.R. 6, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (the “SUPPORT Act”) which was signed into law on October 25. Most stakeholders agree that the bill is a significant step forward in addressing the opioid epidemic, reflecting a range of important policy changes such as initiatives to increase access to medication-assisted treatment (MAT), new grant, pilot and demonstration projects, and a series of changes to Medicaid and Medicare. During the webinar, experts from Manatt Health will review the major health provisions of the new law and implications for states.

Registration (required) at the following link:

New SHVS Resource: Public Charge FAQs

On October 1, State Health and Value Strategies held a webinar on the proposed public charge rule released by the Department of Homeland Security (DHS). Given the large number of questions received during the webinar, Manatt Health produced a Public Charge Proposed Rule: Frequently Asked Questions that condenses the questions into key categories of interest. If the proposed rule is finalized, it will be important to revisit these and other questions to assess the impact of the rule on immigrants as well as states, localities, and health care providers.

Safety Net Programs Reduce Americans’ Material Hardship

A new study released by the Urban Institute found that the social safety net is one tool to help Americans cope with challenges related to paying for housing, food, utilities, or health care. The research focuses on three measures of material hardship: food insufficiency, unmet medical or dental need, and number of hardships experienced. These hardship measures paint a more nuanced picture of people’s well-being than poverty, which focuses on people’s income, not their experiences. The authors found that participation in safety net programs, such as the Supplemental Nutrition Assistance Program (SNAP) or public health insurance reduces the number of hardships low-income families with children experience by 48 percent and reduces the share who experience food insufficiency by 72 percent.

Early Childhood and Medicaid: Opportunities for Partnering

Partnering with state Medicaid/CHIP agencies on common child health and well-being goals can both improve outcomes for children and target resources to children most likely to experience adversity. A new issue brief produced by Nemours Children’s Health System describes strategies for partnerships between state Medicaid/CHIP agencies and the early childhood sector. The brief also provides an overview of Medicaid/CHIP programs in general as well as describes state flexibility under Medicaid/CHIP and the role of managed care. If you’re looking for a summary of the issue brief, check out this blog post by Georgetown University’s Center for Children and Families.