In This Week’s Update

• New SHVS Resource on Sexual Orientation and Gender Identity 
• Recent Efforts to Extend Medicaid Postpartum Coverage
• Medicaid/CHIP Continuous Eligibility for Kids
• Strategies for Growing the Direct Care Workforce
• State Updates: AK, AZ, CA, IL, KS, NC, NY, TX & WI

 

New SHVS Resource on Sexual Orientation and Gender Identity 

State Health and Value Strategies published a new issue brief, Collection of Sexual Orientation and Gender Identity (SOGI) Data: Considerations for Medicaid and Spotlight on Oregon, that documents how information describing sexual and gender minority populations is currently collected at the federal level and in Medicaid. The brief also spotlights Oregon’s recent efforts to improve the collection of SOGI data, and presents several issues that states should consider as they look to improve their collection of SOGI data in Medicaid.

 

In case you missed it, a slide deck and a recording of SHVS’ webinar, State Strategies to Support Afghan Evacuees in Accessing Health Coverage, is now available. The webinar provided an overview of eligibility standards for Afghan evacuees and strategies that states can deploy to expeditiously enroll people into health coverage in order to access care. Presenters also reviewed new CMS guidance to help states understand what health coverage options are available to Afghan evacuees. SHVS will also be releasing a communications flyer soon for states that will be in English as well as in Pashto and Dari to help communicate coverage options to Afghan evacuees. 

 

Recent Efforts to Extend Medicaid Postpartum Coverage and What to Watch Looking Ahead

A new analysis by the Kaiser Family Foundation lays out the latest landscape in federal and state efforts to extend postpartum coverage. Medicaid is a key source of coverage for low-income pregnant people in the United States, covering more than four in ten births nationally, but many people who qualify for Medicaid because they are pregnant lose that coverage 60 days postpartum, especially if they live in a state that has not expanded Medicaid. In recent years there has been a growing interest among state and federal policymakers in extending Medicaid postpartum coverage beyond the 60-day mark to help address racial disparities and improve maternal and infant health. Earlier this year, federal legislation was enacted that gives states a temporary option to extend postpartum coverage beyond 60 days, and Congress is currently considering additional legislation to require such extended coverage. As a reminder and for more information, SHVS has an expert perspective that highlights the new state option under the American Rescue Plan Act to extend postpartum coverage in Medicaid and the Children’s Health Insurance Program and considerations for states.

 

Why is Medicaid/CHIP Continuous Eligibility So Important for Kids?

The number of uninsured kids was going down for many years, but in the last few years that rate started going back up – rising to 5.7 percent child uninsured rate in 2019. While children are insured at higher rates than non-elderly adults, they still lag considerably behind seniors, who are covered at around 99 percent. A new blog post by the Georgetown University Center for Children and Families examines the question of how many children experience a period of uninsurance at some point during the course of a year and found that the universe of kids affected is considerably large – basically one in ten. And when looking at children whose families are low or moderate income (below 250 percent of the federal poverty line), the number continues to grow, rising to 13 percent of kids who experience a gap in coverage at some point during a year or are uninsured for the whole year. Today only 24 states provide continuous coverage eligibility for children in Medicaid and 26 do so in CHIP. A new report from MACPAC finds states that have adopted continuous eligibility are less likely to see as much churn. These gaps in coverage are unsurprisingly more likely to impact kids in communities of color – 14 percent of Latino kids and almost 12 percent of Black kids experienced uninsurance over the course of a year, while White children were lower than the average for kids overall– although gaps in coverage still affect a sizeable 7.3 percent.

 

State Strategies for Sector Growth and Retention of the Direct Care Health Workforce

The National Governors Association (NGA) published a new issue brief that provides a series of multi-sector state and employer strategies to address recruitment and health sector retention of direct care workers while balancing workforce needs, job quality and wages. It focuses largely on jobs that pay less than or close to 200 percent of the federal poverty guideline for a household of three in 2021 or $43,920. The strategies have even greater relevance in the wake of the COVID-19 pandemic, but they are intended as longer-term opportunities to address the broader needs of the industry and direct care workers. Many of the considerations are drawn from strategies traditionally leveraged in broad sector-based workforce development planning, such as engaging workforce development boards and creating apprenticeship pathways. NGA will host a webinar on October 14 to discuss this publication. Interested individuals can register here.

 

State Updates

• Alaska – Health and Social Services Commissioner Adam Crum is featured in the first episode of a new podcast launched by Governor Mike Dunleavy’s office dedicated to reaching Alaskans with state government news. Entitled “FirstHand,” the podcast features familiar state voices, including commissioners and subject matter experts in Alaska Governor Mike Dunleavy’s administration. Crum leads the department that was and is at the center of the state’s fight against COVID-19, and shares in-depth how Alaska has fared against the disease.

• Arizona – The Arizona Health Care Cost Containment System launched a new, web-based, opioid service locator to help Arizonans who are looking for services to treat opioid use disorder, including where to find Naloxone, the opioid overdose reversal medication.
• AHCCCS is holding an online public hearing on Tuesday, October 12,2:00-3:00 p.m. to gather community and provider input regarding the development of bridge housing on the Arizona State Hospital (ASH) grounds for persons with behavioral health needs who are transitioning from homelessness. In 2019, $3 million was allocated from the Housing Trust Fund for the development of bridge housing on the ASH campus. The state has allocated an additional $3 million, $1 million for additional capital costs and $2 million for two years of operations, bringing total project funding to $6 million.

• California
  • Governor Gavin Newsom signed SB 65, the California Momnibus Act, designed to improve maternal and infant outcomes—particularly for families of color. The bill will improve research and data collection on racial and socio-economic factors that contribute to higher rates of maternal and infant mortality in communities of color.
  • Governor Newsom also signed legislation that allows consumers who purchase plans on the state’s marketplace to claim parents as dependents, effective January 1, 2023. California is the only state with such a law in place.
• Illinois – To help increase capacity and facilitate faster access to COVID-19 testing in schools across the state, the Illinois Department of Public Health (IDPH) has partnered with the U.S. Health and Human Services’ Midwest COVID-19 Testing Coordination Center (MCC) to provide testing to all public and private schools that are now seeking to establish a testing program. The partnership will add testing capacity, expedite the testing onboarding process, and tap into additional federal funding under the HHS “Operation Expanded Testing” program.
• Kansas – The state submitted a request to the Centers for Medicare & Medicaid Services (CMS) to amend its “KanCare” section 1115(a) demonstration to add twelve months of continuous eligibility coverage for parents and other caretaker relatives using Modified Adjusted Gross Income. The federal public comment period will be open from October 7, 2021 through November 6, 2021. 
• New York – NY State of Health, New York’s official health insurance Marketplace, announced Danielle Holahan has been named Executive Director. This appointment follows the retirement of NY State of Health Executive Director and NYS Medicaid Director, Donna Frescatore. A health policy expert with over 25 years of state and federal experience, Danielle joined the Marketplace team in April 2011 during its early planning stages and has played a lead role in its development and operation and has overseen its tremendous growth. 
• North Carolina – The North Carolina Department of Health and Human Services announced a significant milestone in the fight against COVID-19: 70 percent of North Carolinians age 18 and older have received at least one dose of the COVID-19 vaccine.
• Texas – The Texas Health and Human Services Commission (HHSC) released a request for proposals for the procurement of Texas STAR Health, the state’s Medicaid managed care program for children and young adults in foster care. Responses are due by December 6, with awards anticipated June 2022. HHSC will award one, six-year contract beginning August 2022, with up to three two-year renewals.
• Wisconsin
  • Governor Tony Evers and the Wisconsin Department of Health Services (DHS) announced the hiring of Dr. Michelle Robinson as the Director of the newly formed Office of Health Equity. The Office of Health Equity and its team is attached to the Office of the Secretary and will lead work to advance diversity, equity, and inclusion within the department while also coordinating the development and implementation of policies and programs to address root causes of health inequities.
  • DHS announced the relaunch of the Testing Pilot Program, now referred to as the Community Testing Support Program, to support entities across Wisconsin in offering local, convenient COVID-19 testing. The program will provide approved applicants with free testing supplies and courier services through