October 18 Update

In this week’s update: 

  • SHVS Publications Review: Affordable Coverage for Immigrants, Funding Mobile Crisis Services, 2022 Open Enrollment 
  • State Updates: CO, DE, MN, NJ, NY & WI
  • Upcoming Webinar: Equity in Medicaid Managed Care
  • State-Based Marketplaces Expanding Via New Federal Grants
  • Home Visiting Programs and Health Equity


State Health and Value Strategies released two new issue briefs and a new expert perspective:

  • State-Funded Affordable Coverage Programs for Immigrants is the first issue brief in a new State Health and Value Strategies’ series Supporting Health Equity and Affordable Health Coverage for Immigrant Populations. This issue brief provides an overview of the national immigrant health coverage landscape and offers considerations for policymakers related to state-funded affordable coverage programs for low-income individuals who do not qualify for subsidized health insurance under the Affordable Care Act (ACA) or other public programs due to immigration status.
  • A Hybrid Funding and Coverage Model to Ensure Universal Access to Mobile Crisis Services presents a sustainable, hybrid coverage and funding approach for mobile crisis services in light of the new federal funding opportunities for states to improve access to behavioral health crisis services. As a reminder, SHVS also hosted a webinar on the American Rescue Plan’s (ARP) new state option for community-based mobile crisis interventions.
  • ACA Marketplaces Well-Positioned for Strong 2022 Open Enrollment Season highlights some observations about the factors that are impacting rate changes this year and the kind of variations that exist among states.


State Updates


  • Colorado
    • The state announced that CMS approved the Colorado health insurance plan that will set the minimum health care coverage requirements starting in 2023. The plan establishes the essential health benefits (EHBs) within Colorado for individual plans and small group plans and will require these plans to cover gender affirming services for transgender individuals as well as annual mental wellness exams and additional non-opioid pain medications. The plan will address substance use disorder by expanding the number of drugs that insurance companies are required to cover in their prescription drug formularies as alternatives to opioids, as well as adding acupuncture treatments. Colorado is the first state in the country to explicitly include gender-affirming care services in its plan.
    • The Colorado Division of Insurance is requesting public review and comment on its Section 1332 waiver amendment request. The waiver amendment request aims to make the Colorado Option available to all Coloradans who buy their health insurance on the individual market and small employers with less than 100 employees starting in 2023. As part of the Colorado Option, the Division of Insurance will create a standardized plan which will allow consumers and businesses to easily compare plans and choose the plan that is right for them. This plan will cover all essential health benefits required by the ACA, provide high value services without consumer cost sharing, and be designed to reduce racial health disparities and improve health equity. Comments will be accepted until November 15, 2021.
  • Delaware – The Delaware Department of Health and Social Services’ Division of Medicaid and Medical Assistance (DMMA) and Division of Developmental Disabilities Services announced immediate efforts to stabilize and strengthen the home and community-based services workforce across Delaware. The state will make targeted payments to recruit and retain the Direct Support Professionals (DSPs) in the state. Each new DSP, employed on or after May 1, 2021, and existing DSPs who were employed prior to April 30, 201, who works or worked a minimum of 25 hours a week could receive a recruitment payment of up to $1,000.
  • Minnesota  
    • Governor Tim Walz announced a further extension of the “Safe Travels, Minnesota” vaccine incentive partnership with Sun Country Airlines encouraging Minnesotans to get their COVID-19 vaccine. Minnesotans who get their Johnson & Johnson vaccine at the state’s vaccination clinic at the MSP Airport from October 8 through December 29 can enter into a weekly drawing for a $200 travel voucher through Sun Country Airlines.
    • Governor Tim Walz also announced a comprehensive COVID-19 action plan to relieve Minnesota’s increasingly crowded hospitals and provide new rapid testing opportunities for Minnesota families. The governor is putting the National Guard on alert to provide staffing support at Minnesota’s long-term care facilities and expanding access to the COVID-19 Emergency Staffing Pool, which allows long-term care facilities to request short-term emergency temporary staffing if they’re experiencing a staffing shortage due to an outbreak of COVID-19 at their facility. The action plan also directs the Department of Human Services to free up capacity at state long-term care facilities.
  • New Jersey
    • Governor Phil Murphy and Department of Banking and Insurance Commissioner Marlene Caride announced nearly $4 million in grant funding for community organizations to serve as state Navigators to provide free outreach, education, and enrollment assistance to residents shopping for health insurance during Open Enrollment Period. The administration is increasing its investment in Navigators this year by nearly half a million dollars, and expanding the number of awardees, to help consumers enroll in quality, affordable health insurance.
    • The New Jersey Department of Human Services is working with leading community organizations and state agencies to strengthen access and improve cultural competency and language access to traumatic brain injury services among Black, Latino(a), and other people of color and non-English speaking communities. The initiative is supported by a cooperative agreement with the HHS Administration for Community Living (ACL) as part of a financial assistance award totaling $1.7 million over five years.
  • New York – Governor Kathy Hochul announced 21 new #VaxtoSchool pop-up vaccination sites to increase vaccination rates among school-aged New Yorkers. The Department of Health is working with local county health departments, community-based organizations, and health care centers on-the-ground to support the establishment of these sites in all regions of the state. Partners, host sites, and outreach efforts are tailored to the communities they are built to serve. New locations are established on a rolling basis in partnership with localities, and more sites will be announced each week over the 12-week period.
  • North Carolina – The North Carolina Department of Health and Human Services expanded its vaccine data dashboard to provide more statewide demographic data for COVID-19 vaccinations. Users will be able to see vaccination rates by race, ethnicity, and age groups. The information will be displayed on a new tab named “Additional NC Demographic Data” on the dashboard. As a reminder, SHVS has an expert perspective tracking state reporting of COVID-19 vaccine data by health equity categories, including race, ethnicity, age, and gender.
  • Wisconsin – The Wisconsin Department of Health Services (DHS) announced funds will be made available to promote racial and geographic equity in the COVID-19 response. DHS was awarded $27 million by the Centers of Disease Control and Prevention to combat inequities related to COVID-19 infection, illness, and death, including $9 million dedicated to rural communities. In a separate appropriation, an additional $13 million in funding has been set aside to continue the Vaccine Community Outreach grant program, which funds organizations across Wisconsin to increase vaccinations by serving as trusted messengers within their communities, build vaccine confidence, and reduce barriers that hinder vaccine access for populations who have been historically marginalized or underserved.


Upcoming SHVS Webinar – Save the Date!

 Promoting Health Equity in Medicaid Managed Care

Monday, November 1 from 1:00 to 2:00 p.m. ET

This webinar, hosted by State Health and Value Strategies, will review steps states can take to integrate health equity into their Medicaid managed care programs. Promoting Health Equity in Medicaid Managed Care: A Guide for States is a practical guide that offers a series of concrete actions state Medicaid agencies can implement internally and with their contracted health plans in pursuit of health equity. Medicaid’s role in providing health care coverage to individuals who experience economic and social disadvantage is leading many states to integrate health equity into their population health management strategies, focusing specific attention on reducing health disparities and addressing conditions that create health inequities. During the webinar, experts from Bailit Health will review the three sections of the Guide and facilitate a discussion with state officials. The webinar will include a question and answer session for participants.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e05e475166033edd4886ee3961c2e3046


Addressing Racial and Ethnic Disparities in Maternal and Child Health Through Home Visiting Programs

Systemic racism within health care and other social institutions has led to large racial and ethnic disparities in access to health care, poor health outcomes, and high mortality rates for women and children of color. Evidence-based home visiting programs can help reduce racial and ethnic health disparities by providing mothers with screenings, case management, family support, and referrals that address a family’s physical, mental, and health-related social needs. The Center for Health Care Strategies published a new issue brief, made possible by the Robert Wood Johnson Foundation, that explores strategies used by state Medicaid and health agencies in New York, Minnesota, and Vermont to improve equitable health and well-being outcomes through their home visiting programs. Using culturally responsive, community-driven, and anti-racist approaches to support under-resourced communities can help home visiting programs increase opportunities to identify and address racial inequities and disparities, as well as improve maternal and early childhood outcomes.


State-Based Marketplaces Eye Health Equity, Expanding Enrollment Under New Federal Grants

A new post on the CHIRblog, published by Georgetown’s Center on Health Insurance Reforms, examines how State-Based Marketplaces (SBMs) are planning to spend the $20 million in grant funding announced by the Centers for Medicare & Medicaid Services last month. The federal funding, allocated under the ARP, will allow SBMs to modernize their technology platforms, outreach programs, and other systems and operations to ensure compliance with federal requirements, including the ARP’s temporary subsidy expansion. The blog post highlights how, after achieving substantial enrollment through their initiatives to connect consumers to marketplace plans, the new grant funding will allow SBMs to build on their progress. As states prepare for the end of the PHE and address the ongoing hardships brought by the pandemic, investing in more equitable outreach and consumer assistance, and improved eligibility and enrollment systems will ensure that SBMs can continue to provide access to affordable, quality coverage.


Leveraging Federal Dollars to Transform Home- and Community-Based Services

In March, Congress provided states with a temporary 10 percentage point increase in federal Medicaid matching funds for home- and community-based services (HCBS) in the ARP. These services, which range from personal care and respite for caregivers to job coaching and adult day programs, allow millions of Americans with complex needs or disabilities to live safely in their homes and communities. The National Association of Medicaid Directors, in partnership with Advancing States and the National Association of State Directors of Developmental Disabilities Services, recently published a blog post on how states are using the additional funding for HCBS in transformative ways. As a reminder, SHVS published an issue brief describing the ARP’s HCBS enhanced FMAP provision and CMS’s implementation guidance.