October 26 Update

In This Week’s Update:

  • New SHVS Health Equity Resource Page
  • COVID-19 Expert Perspectives
  • COVID-19 State Updates: DE, MA, NC, NJ, PA, WA & WI
  • Other State Updates: CA, NE, OK, PA, WA & WI
  • Webinar: Changes in the Coverage Environment During COVID-19
  • Webinar: Driving Reductions in Health Care Disparities
  • Supreme Court Vacancy and the ACA
  • COVID-19 Social Care Playbook


New SHVS Health Equity Resource

State Health and Value Strategies (SHVS) launched last week a new resource page for state health officials on health equity. SHVS developed the resource page to serve as an accessible one-stop source of information about health equity for states, where all SHVS health equity publications and webinars, as well as materials produced by states, the federal government, and other organizations, can be found. The resource page is organized by topic area and includes content on data and measurement, Medicaid and health equity, engagement/communications, and telehealth and health equity, among other topics. If you have materials you are willing to share with other states through the resource page, or if there are topics of particular interest that you would like to see included, please contact SHVS.


COVID-19 Expert Perspectives

Also last week, SHVS published two new expert perspectives for states related to the COVID-19 pandemic. While the timeline for when a vaccine may be available is not yet clear, states are establishing advisory groups and beginning to plan for vaccine distribution. Ensuring Access to the COVID-19 Vaccine for Adult Medicaid Enrollees: A Roadmap for States is intended to support Medicaid officials as they assess their vaccine coverage policies and, if necessary, close any coverage gaps that might otherwise inhibit vaccine uptake during a crucial period of mass immunization. In addition, as states prepare for the open enrollment period in the midst of significant churn between Medicaid and the marketplaces, Collaborating to Connect Consumers to Coverage highlights messages to encourage consumers to check out coverage options during open enrollment and profiles two state examples of coordination to ensure consumers encounter “no wrong door” in their search for coverage. As a reminder, you can find all SHVS COVID-19 products, as well as the latest federal guidance and notices of funding opportunities, on the SHVS COVID-19 resource page.


COVID-19 State Updates: DE, MA, NC, NJ, PA, WA & WI

  • Delaware – Governor John Carney and the Delaware Department of Health and Social Services announced the creation of a Health Care Relief Fund to support Delaware health care providers through the COVID-19 crisis. The $100 million fund will support providers throughout the health care industry that have been on the front lines fighting COVID-19 in Delaware. This includes home health care agencies, intellectual and developmental disability providers, nursing homes and assisted-living facilities, behavioral health service providers, and hospital systems. Healthy Communities Delaware, a statewide public-private partnership that works to address social determinants of health (SDOH), will also receive funding for distribution to Delaware communities that have been disproportionately affected by COVID-19.
  • Massachusetts – The Massachusetts Health Connector, the Massachusetts state-based exchange, selected 18 community-based navigator organizations to provide health insurance enrollment help to residents, including 10 with newly expanded capacity to provide additional support during the COVID-19 pandemic. Due to COVID-19, the Health Connector’s walk-in centers remain closed. In order to help applicants and members who rely on the walk-in center for support, the Health Connector is providing additional capacity opportunities by having these 10 navigator organizations maintain additional support through September 2021. These organizations will provide additional staff and hours to support people who need help or have questions about their coverage.
  • New Jersey
    • Human Services Commissioner Carole Johnson and Department of Children and Families Commissioner Christine Norbut Beyer announced the departments will use federal Coronavirus Relief Fund resources to provide up to $25 million to help providers of home health, developmental disability, child welfare, and homeless services remain open and accessible during the pandemic by reimbursing for the added costs they are incurring due to COVID-19 for essentials such as personal protective equipment and enhanced cleaning. 
    • Governor Phil Murphy signed legislation which requires public health emergency credits to be awarded to certain inmates and parolees during a public health emergency. Under the bill, public health emergency credits would be awarded to any adult inmate or juvenile who is within 365 days of their scheduled release. Credits would accrue at the rate of 122 days (four months) for each month, or portion of each month, served during the declared emergency with a maximum of 244 days (eight months) of remission to be awarded for any declared emergency period. The legislation includes certain exclusions and prohibits inmates or parolees to contact their victims upon their release.
  • North Carolina – The North Carolina Department of Health and Human Services Division of Health Benefits (NC Medicaid) is extending temporary provider rate increases related to COVID-19 through the end of the federal COVID-19 public health emergency, which goes through Jan. 21, 2021.
  • Pennsylvania – The Wolf Administration participated in a National Academies of Sciences, Engineering and Medicine project which resulted in a report: Decarcerating Correctional Facilities During COVID-19. The report, which was funded by Arnold Ventures and the Robert Wood Johnson Foundation, offers guidance on efforts to decarcerate, or reduce the incarcerated population, as a response to the COVID-19 pandemic.
  • Washington – Governor Jay Inslee announced the Washington COVID-19 Immigrant Relief Fund is now open for applications. The relief fund will provide $40 million in federal funds allocated by the state to assist Washington workers who miss work due to COVID-19 but are unable to access federal stimulus programs and other social supports due to their immigration status. While the fund is operational, eligible recipients will receive $1,000, with a limit of $3,000 per household. 
  • Wisconsin – The Department of Health Services released a new data dashboard that displays COVID-19 cases, hospitalizations, and deaths by race and ethnicity. This new visualization helps illustrate some of the unequal health outcomes of COVID-19, particularly for people of color. The race and ethnicity dashboard is part of an ongoing effort to close health disparities throughout the state by promoting tools and resources centered on health equity. For more information and other examples of state activity, see the SHVS expert perspective on Advances in States’ Reporting of COVID-19 Health Equity Data.


Other State Updates: CA, NE, OK, PA, WA & WI

  • California – Covered California, the California state-based exchange, announced that the renewal process for a record number of enrollees is now underway, with more than 1.5 million Californians eligible to renew their coverage. In addition, the preliminary rate change that Covered California previously announced in August has been revised downward to a new all-time low of 0.5 percent for the 2021 plan year.
  • Nebraska – CMS announced its approval of Nebraska’s new Medicaid Section 1115 demonstration called “Heritage Health Adult.” This demonstration is designed to create a pathway for certain Nebraska adults with newly gained Medicaid coverage to access additional benefits if they participate in certain activities to promote health and independence, including wellness initiatives, personal responsibility activities, and community engagement activities. This demonstration is effective October 20, 2020 through March 31, 2026, with implementation beginning April 1, 2021.
  • Oklahoma – The Oklahoma Health Care Authority (OHCA), Oklahoma’s Medicaid agency, released a Request for Proposals to contract with Managed Care Organizations (MCOs) to deliver risk-based managed care services to SoonerCare children, deemed newborns, pregnant women, parent and caretaker relatives, and expansion adults. OHCA also intends to contract with one MCO to deliver statewide, risk-based managed care services for SoonerCare eligibles who are former foster children, juvenile justice-involved, in foster care, or children receiving adoption assistance.
  • Pennsylvania
    • The Department of Insurance announced Pennsylvania’s approved 2021 individual and small group Affordable Care Act (ACA) health insurance rates, highlighting a statewide average decrease of 3.3 percent in individual market rates, attributable to the new state-based exchange and reinsurance program.
    • Secretary of Health Dr. Rachel Levine shared a tool that highlights the critical questions for Pennsylvanians to ask their health care providers so patients can improve their health literacy to make appropriate health decisions, especially as COVID-19 and the flu remain a threat to Pennsylvanians.
  • Washington – The Washington Health Benefit Exchange (WAHBE), Washington’s state-based marketplace, is seeking to contract with one vendor/consulting firm to explore how the health of customers can be further improved and how persistent disparities can be further reduced by addressing SDOH. This will require exploring how WAHBE’s statutory authority, organizational strengths, internal resources, existing partnerships, and upcoming projects/strategic initiatives could be leveraged and identifying where WAHBE is uniquely positioned to contribute.
  • Wisconsin – The Department of Human Services announced that, beginning October 24, 2020, Medicaid members who are incarcerated will have their health care benefits suspended and then reevaluated before they are released from jail or prison so that they have coverage immediately upon release. Previously, Medicaid members who became incarcerated had their coverage terminated, which then often delayed their access to medical and behavioral health care following their release.


Webinar: Changes in the Coverage Environment During COVID-19

Friday, October 30, 2020, 2:00 to 3:00 p.m. EST

State Medicaid agencies and Marketplaces are facing intense pressure as coverage volatility resulting from the COVID-19 economic downturn continues and the 2021 open enrollment period begins. Millions of people have already lost jobs and, in many cases, their employer-sponsored insurance, and the number of individuals entering the unemployment ranks for the first time remains high. Additionally, the eventual (and unknown) end to the public health emergency adds to the dynamic of coverage churn in and across Medicaid and the Marketplaces, making it more critical than ever that states prepare for increases and shifts in enrollment. SHVS is hosting a webinar during which experts from Manatt Health and GMMB will review the trajectory of 2020 Medicaid enrollment growth to date and provide effective strategies for communication with members and coordination across state Medicaid agencies and Marketplaces to support coverage access and retention in this dynamic environment.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=ef98237b8a31e465d8d32e6dd3407776b


Webinar: Driving Reductions in Health Care Disparities

Catalyst for Payment Reform is hosting a webinar series featuring innovative health purchasers and their strategies focused on bundled payment, health care disparities, and mental health. On Thursday, October 29, the second webinar in the series will feature Taylor Priestley, Health Equity Officer, and Doug McKeever, Chief Deputy Executive Director, of the Covered California Health Exchange, who will discuss the work Covered California has done to address health disparities. Measuring and reducing health care disparities is of critical importance for employers and other health care purchasers, yet accessing the right data to understand the problem remains a challenge. Covered California will share its best practices and lessons regarding data-driven approaches to improve health equity. Covered California is included in the SHVS publication Medicaid Managed Care Contract Language: Health Disparities and Health Equity, which provides excerpts of health disparities and health equity contract language from Medicaid Managed Care contracts in eight states.


The Supreme Court Vacancy and the Affordable Care Act

Manatt Health hosted a webinar recently that examined how the vacancy on the Supreme Court as a result of the death of Justice Ruth Bader Ginsburg might affect a ruling on California v. Texas, the lawsuit challenging the constitutionality of the ACA. The Supreme Court is scheduled to hear oral arguments in California v. Texas on November 10 and it is possible that Justice Ginsburg’s replacement could be appointed to the Court prior to November 10. The webinar explored how the ruling could affect the approximately 20 million people who have gained coverage through ACA Marketplaces and Medicaid expansion, as well as the of tens of millions of other Americans affected by some aspect of the law, such as preexisting condition protections. Panelists also examined the central legal questions under consideration in the case as well as when to expect a decision, and the potential outcomes of the case. Manatt also published a companion summary authored by two of the webinar panelists this week.  


COVID-19 Social Care Playbook

The COVID-19 global pandemic is having a major and protracted effect on individuals, families, and communities. In addition to the direct health consequences of the pandemic, there are secondary social effects of anxiety, fear, economic uncertainty, and social isolation as well. People and communities that historically have been underserved are likely to suffer the greatest from the direct and indirect effects of the pandemic, and people who previously had no unmet social needs might experience them. Additionally, there are disparities by race and ethnicity for those testing positive for COVID-19, given longstanding systemic and social inequities in the United States. Kaiser Permanente’s COVID-19 Social Health Playbook provides guidance on caring for patients with social needs within a COVID-19 context. The playbook includes information on how to assess patients’ social needs, connect them to resources to address those needs, and follow up to ensure needs were met and to coordinate care as appropriate. Additional considerations are included for seniors, those with behavioral health needs, and victims of intimate partner violence.