October 13 Update

In This Week’s Update:

  • Renewal of Public Health Emergency
  • Tracking Medicaid Enrollment Growth
  • COVID-19 State Updates: MA, NC & VA
  • Other State Updates: AZ, CA, CO, CT, KY, NC, NM, OH, PA & VA
  • Children’s Uninsured Rates on the Rise
  • New Mothers’ Access to Health Care
  • Theme Issue on Drivers of Health

 

Renewal of Public Health Emergency

United States Department of Health and Human Services Secretary Alex Azar announced on October 2 that he is again renewing the Public Health Emergency (PHE) Declaration, effective October 23, 2020. The PHE is now set to expire on January 20, 2021, absent another renewal. In light of the renewal, State Health and Value Strategies (SHVS) updated Federal Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts: Effective and Expiration Dates, which summarizes the effective dates and current expiration timelines for various emergency measures.

 

Tracking Medicaid Enrollment Growth

Last week SHVS published Tracking Medicaid Enrollment Growth During COVID-19 Databook, which includes Medicaid enrollment data from over 40 states and provides a comprehensive, detailed look at 2020 Medicaid enrollment trends to-date. As a companion to the Databook, Manatt Health authored an Overview that summarizes key findings from an analysis of the enrollment data. The resource aims to help with both examining state enrollment trends and contextualizing those trends in comparison with other states.

 

COVID-19 State Updates: MA, NC & VA

  • Massachusetts – The Baker-Polito Administration announced over $5.5 million in grants to address urgent food insecurity for Massachusetts residents as a result of the COVID-19 pandemic.
  • North Carolina – The North Carolina Department of Health and Human Services (NCDHHS) partnered with United Providers of Health to address unmet health care needs of historically marginalized communities. A new $7 million statewide effort will support the NCDHHS COVID-19 response by providing preventive health care services, connections to mental health supports, and help securing nonmedical drivers of health like food and housing.  
  • Virginia – Governor Ralph Northam announced he is directing $12 million in additional funding from the federal CARES Act to Virginia’s Rent and Mortgage Relief Program due to high demand for financial assistance. The program assists households and landlords with rent and mortgage payments to avoid eviction or foreclosure due to COVID-19.

 

Other State Updates: AZ, CA, CO, CT, KY, NC, NM, OH, PA & VA

  • Arizona — The Arizona Health Care Cost Containment System (AHCCCS) announced that managed care plans are now offering a $10 gift card to every AHCCCS member who receives a flu shot this season.
  • California – Covered California for Small Business unveiled the health plan choices and rates for small-business employers and their employees for the upcoming 2021 plan year. The statewide weighted average rate change will be 1.5 percent, which represents the lowest annual increase in the program’s seven-year history, and is significantly lower than national projected increases for larger employers.
  • Colorado – The Colorado Division of Insurance announced the reinsurance program continues to deliver significant savings for Coloradans buying individual health insurance (i.e., a plan not from an employer). For 2021, the reinsurance program will save consumers across Colorado an average of 20.8 percent over what premiums would have been without the program.
  • Connecticut – Access Health CT, the state-based exchange, announced a series of upcoming virtual educational sessions known as “Healthy Chats.” The purpose of these online events is to help Connecticut residents become familiar with the marketplace and the available tools to get coverage during the open enrollment period. Healthy Chats can help Connecticut residents learn about plan options, financial help, low-cost and free coverage, and tips to stay covered.
  • Kentucky – Governor Andy Beshear announced the state has reconnected kynect, the Kentucky state-based exchange, in order to provide easier access to health coverage and other benefits. The platform offers expanded benefits, enhanced usability, a new mobile-friendly format, and helps to ready the commonwealth for the return of the state-based exchange, scheduled for enrollment in 2021 to begin the exchange in January 2022. The move is expected to save Kentuckians about $15 million a year.
  • New Mexico – The New Mexico Human Services Department announced the online publication of its Department Performance Scorecard, which is designed to demonstrate transparency and show the public its priorities and performance. With a total of 31 measures, the scorecard categorizes measures by the department’s four goals related to member improvement in receiving timely and accurate benefits, transparent communication, technology upgrades, and an environment of mutual respect and trust.
  • North Carolina – The North Carolina Department of Health and Human Services Division of Mental Health, Developmental Disabilities and Substance Abuse Services is partnering with UNC-TV and the Governor’s Institute to host several virtual mental health town hall meetings during October and November to listen to the concerns and experiences of consumers, family members, and advocates of the state’s mental health/developmental disabilities/substance abuse services and system. 
  • Ohio – The Ohio Medicaid program released a request for applications to solicit applications from managed care organizations (MCO) as the state seeks to design a new managed care program. The selected MCOs will be part of a reimagined Medicaid managed care program that unbundles the current program and will include a new single, statewide, prepaid inpatient health plan. The OhioRISE Plan will provide behavioral health services to children with serious/complex behavioral health needs that are at risk or in foster care, as well as a single pharmacy benefit manager responsible for providing and managing pharmacy benefits for all Medicaid enrollees.
  • Pennsylvania – Governor Tom Wolf unveiled a new health reform plan that addresses comprehensive health reforms focusing on both physical and behavioral health and promoting affordability, accessibility, equity, and value in health care. The plan includes the establishment of an interagency health reform council, the formation of regional accountable health councils into managed care agreements, and the establishment of a health value commission with the state legislature.
  • Virginia – The Virginia Department of Medical Assistance Services (DMAS) is seeking participants for its 2021 Medicaid Member Advisory Committee. This advisory committee—made up entirely of Virginia Medicaid members or their authorized representatives—will help review health policies and services, making recommendations to the DMAS Director.

 

Uninsured Rates Among Children Rising

Between 2013 and 2016, children’s uninsurance fell, their Medicaid/Children’s Health Insurance Program (CHIP) participation rate rose, and the number of children eligible for Medicaid/CHIP but uninsured declined, according to American Community Survey data. A new report from the Urban Institute documents that these gains stalled in 2017 and 2018, as children’s uninsurance rose and program participation fell relative to 2016 levels. In 2018, consistent with prior years, children’s uninsurance and Medicaid/CHIP participation rates varied across states, and long-standing disparities in coverage and participation across subgroups continued. Also like in previous years, more than half of uninsured children appeared to be eligible for Medicaid/CHIP but not enrolled. Further, just over half of all Medicaid/CHIP-eligible but uninsured children in 2017 and 2018 lived in just seven large states (Arizona, California, Florida, Georgia, New York, Pennsylvania, and Texas).

 

New Mothers’ Health Care Access and Affordability Under the Affordable Care Act

The Urban Institute published an issue brief that examines changes in access to, and affordability of, health care services for new mothers under the Affordable Care Act (ACA) using data from the National Health Interview Survey. Though thousands of new mothers gained insurance coverage following implementation of the coverage provisions of the ACA in 2014, there has been little documentation of changes in those mothers’ health care access and affordability. Comparing data from 2011 through 2013 and 2015 through 2018, researchers found that new mothers were less likely to report having unmet health care needs due to cost and being very worried about paying their medical bills. Even after these improvements, more than 1 in 10 new mothers remained uninsured and nearly 50 percent were at least somewhat worried about paying their medical bills.

 

Health Services Research 2020 Theme Issue on Drivers of Health

Sponsored by the Robert Wood Johnson Foundation, Drivers of Health released the Health Services Research (HSR) 2020 Theme Issue on Drivers of Health. This open-access issue includes fourteen cutting-edge, peer-reviewed articles that illuminate social determinants of health and social/health care system interventions that promote well-being. The articles highlight the myriad relationships between social and health care system factors and health, spanning racism, paid family leave, policing, food insecurity, and more. Findings not only reveal the interconnected ways that social determinants of health influence health outcomes, but drive forward the conversation on the implications for United States health care and social policy.