October 11 Update

Open Enrollment Period 2022-23 Messaging

In preparation for the launch of open enrollment, SHVS published sample messages that states can use to support outreach and enrollment. This open enrollment period will see a continuation of enhanced subsidies and for some states, implementation of a fix to the so-called “Family Glitch.” The sample messages draw on research with consumers to provide states with messaging that can be customized to drive enrollment. 


Addressing Health-Related Social Needs Through Medicaid Managed Care

States are using a variety of approaches to measure and incentivize Medicaid managed care (MMC) entities to address unmet social needs that can contribute to poor health outcomes, lower quality care, and higher medical expenditures. SHVS published a toolkit that identifies examples of approaches states are taking through their MMC programs to address health-related social needs. States interested in implementing specific strategies related to social determinants of health (SDOH) can use this toolkit to develop managed care procurements or update and operationalize key contract provisions. The toolkit does not include all state MMC procurement questions or contract language related to addressing enrollees’ SDOH needs, but instead represents a curated list of specific examples from 16 profiled states. The toolkit was co-funded by the Health Foundation of South Florida.


Center for Health and Wellbeing Launches Princeton Pulse Podcast

The Center for Health and Wellbeing at Princeton University launched “The Princeton Pulse Podcast,” a new podcast exploring the power and possibilities of evidence-informed health policy. The podcast is hosted by Heather Howard and brings together scholars, policymakers, and other leaders to examine today’s most pressing health policy issues—domestically  and globally. In the inaugural episode, Heather Howard is joined by New Jersey First Lady Tammy Snyder Murphy and Elizabeth Armstrong, associate professor of sociology and public affairs, to confront the racial divide in maternal and infant health.


CMS Sets Parameters for Optional Health Home Benefit for Medically Complex Children

CMS released a state plan amendment template and implementation guide on health homes services for Medicaid-eligible children with medically complex conditions (the template can be accessed here). This information follows the August 2022 guidance in which CMS outlined at a higher level the expectations for states that adopt this optional benefit. States may adopt this optional benefit beginning October 1, 2022, and will receive a 15-percentage-point increase in their federal Medicaid matching rate (up to a maximum of 90%) for the first six months the benefit is in operation.


State updates: IN, MI, MN, & more 

  • Indiana – The Indiana Family and Social Services Administration announced that a statewide commission of 24 elected officials, stakeholders and behavioral health providers has concluded its two-year examination of Indiana’s behavioral health delivery system and issued its final report to the Indiana General Assembly. The report from the Indiana Behavioral Health Commission makes recommendations regarding infrastructure in the mental health space and workforce needs, as well as funding recommendations.
  • Michigan – Governor Whitmer signed an executive directive to determine how the state of Michigan can lower the cost of insulin, including by developing its own manufacturing capabilities. Michigan is home to over 912,000 Michiganders with diabetes. If the state can feasibly manufacture insulin, it could lower costs for families and create jobs for Michiganders.
  • Minnesota – MNsure, Minnesota’s official health insurance marketplace, announced new estimates of how much Minnesotans will pay for health premiums in 2023—roughly 3.5% less than in 2022. MNsure projects Minnesota families will save $560 per month, on average, on 2023 coverage with tax credits through MNsure. The estimates are based on final rates available from the Minnesota Department of Commerce.
  • Nebraska – The Nebraska Department of Health and Human Services announced an upcoming Medicaid listening tour to take place across seven cities, as well as two virtual options. The listening tour will include a presentation from Nebraska Medicaid that will focus on new information for members, including the newly selected provider contracts and other important updates. After the presentation, time will be reserved in which members of the public can ask questions or give feedback.
  • Nevada – The Nevada Department of Health and Human Services announced that, in coordination with Governor Steve Sisolak and Attorney General Aaron Ford, a task force will be created to address the increasing rates of fatal and non-fatal overdoses. The Joint Advisory Task Force will determine necessary action to reduce the risk of overdose in Nevada’s communities.
  • New Jersey
    • Governor Phil Murphy announced a new infrastructure for student mental health, the New Jersey Statewide Student Support Services (NJ4S) network, operated by the Department of Children and Families. The NJ4S network will consist of regionally based hubs that will offer a tiered menu of evidence-based prevention and intervention strategies. The NJ4S network will provide universal supports to all New Jersey students, and more intensive supports to students in schools with higher needs.
    • The New Jersey Department of Banking and Insurance announced expanded health insurance options in 2023, with historic levels of financial help available. For the upcoming year, New Jersey has expanded the number of carriers offering plans through Get Covered New Jersey (the state’s official health insurance marketplace) to five, up from three in 2020, and will continue to provide record levels of financial help to lower premiums.
  • North Carolina – The North Carolina Department of Health and Human Services (NCDHHS) released the 2022-2026 Perinatal Health Strategic Plan, as part of NCDHHS’ priority work to improve child and family wellbeing. The plan outlines three primary goals: addressing economic and social inequities, strengthening families and communities, and improving healthcare for all people of reproductive age. NCDHHS will work with multiple organizations, counties and communities as they take ownership of different parts of the plan so that the overall goals can be achieved.
  • North Dakota – The North Dakota Health and Human Services agency’s Behavioral Health Division launched a mental health program directory to better help North Dakotans locate and access mental health services in the state. The new directory allows users to search for mental health programs by location, population served, type of mental health specialty and treatment and interventions options. People can also search for programs that offer telehealth services.
  • Ohio – Governor Mike DeWine announced he is enhancing his Bold Beginning Initiative to remove barriers to healthcare, ease financial burdens, and support parents. As part of the expanded initiatives, Governor DeWine plans to work with the legislature to increase eligibility for Medicaid-sponsored healthcare to pregnant individuals and children in families earning up to 300% of the federal poverty level.
  • Oklahoma – The Oklahoma Health Care Authority board voted to approve a 25% rate increase for private duty nurses, a 5% aggregate rate increase for pediatric dental providers, and a 14% aggregate rate increase for adult dental providers. The rate increases are contingent upon approval by CMS.
  • Oregon – The Oregon Health Authority released a new report, Opioids and the Ongoing Drug Overdose Crisis in Oregon, which shows that opioid overdoses increased in 2021. Overdoses involving multiple drugs—known as polysubstance overdoses—also rose during 2021 and now account for more than half of all fatal overdoses. The report notes trends in interventions, such as an increase in the administration of naloxone by emergency medical services personnel from 3,758 encounters in 2019 to 5,556 encounters in 2021.
  • Pennsylvania – Governor Tom Wolf announced an expansion of Acting Secretary of Health and Pennsylvania Physician General Dr. Denise Johnson’s naloxone standing orders that allow residents to obtain naloxone products to help combat the rise of overdoses in Pennsylvania. Residents can present a copy of the standing order, which is available online, at their local pharmacy to obtain the life-saving naloxone.
  • Washington
    • The Washington Health Benefit Exchange (the state’s official health insurance marketplace) announced new state-funded premium subsidies called Cascade Care Savings. More than 40% of Washingtonians who get their health insurance through Washington Healthplanfinder could receive the new subsidies when enrolling in coverage for 2023. Building upon high-quality Cascade Care plans introduced in 2021, Cascade Care Savings is for Washingtonians making up to 250% of the federal poverty level.
    • The Washington Health Care Authority announced the distribution of a $100 million workforce provider relief fund to address the workforce challenges of licensed behavioral health treatment agencies. In January 2023, behavioral health treatment providers will begin receiving a 7% increase in their Medicaid reimbursement rates.
  • Wisconsin – The Wisconsin Department of Health Services (DHS) is seeking applications for grants to fund behavioral health workforce training. The training must build provider capacity to deliver mental health and substance use services that respect and respond to the beliefs, practices, and needs of diverse communities. This is the second year of this grant program, which was created to respond to a need identified in a DHS-commissioned study about gaps in Wisconsin’s behavioral healthcare system.