October 21 Update

In This Week’s Update:

  • Immigration and Health Care Proclamation
  • State Updates: CT, NC, NY, PA, TX, VA & WA
  • Medicaid MCOs and Health Equity
  • Standardizing Health Plan Benefit Design
  • New Data on Adverse Childhood Experiences
  • Results from 50-state Medicaid Budget Survey


Immigration and Health Care Proclamation

Earlier this month, President Trump issued a proclamation that requires immigrants to show that they have health insurance or can pay medical expenses out of pocket in order to receive a visa. In a new expert perspective posted on the State Health and Value Strategies website, experts at Manatt Health review the latest policy regarding uninsured noncitizens and provide their take on implications for states.


State Updates: CT, NC, NY, PA, TX, VA & WA

  • Connecticut – Access Health CT, the state’s official health insurance marketplace, hosted their fourth annual Community Conference, connecting community partners, enrollment specialists, and other stakeholders to update them on important topics ahead of open enrollment, which begins November 1, 2019.
  • North Carolina – Open enrollment for Medicaid managed care began statewide on Monday of last week, expanding from the initial 27 counties that launched in mid-July to all 100 counties and an additional 860,000 people. Enrollment packets were mailed over the last two weeks to the remaining 73 counties and an enrollment website is also available to help people learn more about their options, enroll in a health plan, and select a primary care provider. Also last week, NCCARE360, the state’s first coordinated care network that knits together health care, human services, and community-based organizations to deliver person-centered care, announced its 1,000th referral.
  • New York – NY State of Health, the state’s official health insurance marketplace, announced the health insurance options available to New Yorkers in 2020. Nearly all marketplace enrollees will see no increase in costs in 2020, including enrollees in Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans (QHP) who receive tax credits. Consumers who receive premium tax credits, typically about 60 percent of QHP enrollees, will see no change—or in some cases a small decrease—in the cost of coverage compared to 2019.
  • Pennsylvania
    • The Pennsylvania Department of Human Services issued a request for applications for its HealthChoices Physical Health Medicaid managed care contracts. The selected Medicaid managed care organizations will serve the five HealthChoices zones covering all 67 counties, with multiple MCOs being selected for each of the five regions.
    • Insurance Commissioner Jessica Altman announced Pennsylvania’s approved 2020 individual and small group Affordable Care Act (ACA) health insurance rates. All insurers currently offering coverage in Pennsylvania’s 67 counties will continue to provide plans in 2020 with a statewide average increase of 4 percent for individual market plans and 9.7 percent in the small group market.
  • Texas – Texas Health and Human Services released its inaugural business plan, Blueprint for a Healthy Texas, which outlines specific, measurable initiatives for the agency. As a guide for long-term improvement, the 12 initiatives and 72 goals outlined in the plan focus on how the system’s two agencies—the Texas Health and Human Services Commission and the Department of State Health Services—will improve operations, customer service, and workplace culture.
  • Virginia – Governor Ralph Northam issued Executive Directive Five, requiring the state to explore strategies to reduce health insurance premiums statewide. The Secretary of Health and Human Resources, in collaboration with the Secretaries of Finance and Public Safety and Homeland Security, will review policies and programs and take actions to promote greater access and enrollment in quality, affordable health insurance coverage. 
  • Washington – Washington Health Benefit Exchange announced locations for eleven full-service enrollment centers offering in-person assistance to customers signing up for health and dental coverage through Washington Healthplanfinder during the upcoming open enrollment period starting November 1.


The Medicaid MCO Experience in Addressing Health Equity

Tuesday, October 22, 2:00 to 3:00 p.m. ET

State Health and Value Strategies is convening the fifth, and last, webinar in its series SHVS Health Equity Through Managed Care. For many states, eliminating disparities in Medicaid managed care programs means working with their MCO contractors, and implementing contractual requirements that advance health equity. The upcoming webinar, The Medicaid MCO Experience in Addressing Health Equity, will profile the work of one MCO, HealthPartners, in addressing equity issues within its Medicaid line of business. The webinar will hear from Brian Lloyd, who manages Health Partners’ organization-wide equity initiative, which includes collecting data to eliminate disparities in care, supporting language access, partnering with communities, and building an organizational understanding of equity, diversity, inclusion, and bias. 

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=ee00973dbf7a8247a1e8626da3962c699


Standardizing Health Plan Benefit Design in the Individual Market: Opportunities and Implications

Wednesday, November 6, 1:00 to 2:00 p.m. ET

State Health and Value Strategies will host a webinar on the opportunities for states to implement standardized benefit designs, either through their health insurance marketplace or as part of a public option plan. The webinar will explore issues to consider in developing standardized options, communicating with stakeholders, and leveraging standardized designs to improve affordability for enrollees and encourage maintenance of coverage. The webinar will also review the development of standardized designs through state-based marketplaces, their connection to public option proposals, operational requirements to improve the end-user experience, and data collection and analysis needs.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e3cade0aaf60b554a6a16870264d01a07


New HRSA Data Show One in Three US Children Have Suffered an Adverse Childhood Experience

The Health Resources and Services Administration (HRSA) released data from the 2018 National Survey of Children’s Health (NSCH) which shows that in 2017 and 2018, one in three children under the age of 18 were reported to have suffered at least one adverse childhood experience (ACE) in their lifetime and 14 percent experienced two or more ACEs. The American Academy of Pediatrics describes ACEs as stressful or traumatic events that occur during childhood and are strongly related to a wide range of health problems throughout a person’s lifetime. According to the latest NSCH data, the most prevalent ACE in children’s lifetime was “Parent/guardian divorced or separated” (23.4%), followed by “Lived with anyone with alcohol/drug problem” (8.0%) and “Parent/guardian served time in jail” (7.4%).


Medicaid Enrollment & Spending Growth: FY 2019 & 2020 and Key Medicaid Policy Changes

The Kaiser Family Foundation published two reports based on 50-state Medicaid budget survey of state Medicaid directors. The first is an analysis of national trends in state Medicaid enrollment and spending in FY2019 and FY2020. The second, completed in partnership with the National Association of Medicaid Directors, presents detailed, state-specific information on Medicaid policies and programs. According to the survey results, state officials expect total Medicaid spending to climb 6.2 percent with enrollment remaining virtually flat. Officials identified increasing costs for prescription drugs, provider rate increases, and pressures from the aging population and long-term care costs as key upward drivers of total Medicaid spending. The annual survey also examines state-specific changes and initiatives taking place in Medicaid programs. Other key highlights include state initiatives to address social determinants of health through managed care contracts and outside of managed care and an array of efforts (through eligibility, benefits, and delivery system changes) to help reduce maternal mortality and improve infant birth outcomes.