October 4 Update

Latest Medicaid and CHIP enrollment numbers

Last week CMS released the latest enrollment report for Medicaid and CHIP. As of June 2022, just over 89,440,000 people were enrolled in Medicaid and CHIP, an increase of 465,369 compared to the previous report. Since February 2020, enrollment in Medicaid and CHIP increased by 18,752,902 individuals, or 26.5%, the result of the continuous coverage requirement. As states plan for the end of the public health emergency and the end of the continuous coverage requirement, Medicaid agencies will undertake the massive task of redetermining eligibility for a historic number of enrollees.

National strategy on hunger, nutrition and health

President Biden hosted the White House Conference on Hunger, Nutrition, and Health to catalyze action for the millions of people in the United States struggling with food insecurity and diet-related diseases like diabetes, obesity, and hypertension. President Biden announced a goal of ending hunger and increasing healthy eating and physical activity by 2030 to reduce diet-related diseases and related health disparities. To advance the President’s goal, the strategy identifies ambitious and achievable actions across five pillars: (1) improving food access and affordability; (2) integrating nutrition and health; (3) empowering all consumers to make and have access to healthy choices; (4) supporting physical activity for all; and (5) enhancing nutrition and food security research.

Robust, Diverse, and Resilient Behavioral Health Workforce in Massachusetts

The COVID-19 pandemic increased the prevalence of behavioral health issues and demand for services, exposing and aggravating the vulnerabilities of Massachusetts’ behavioral health workforce and delivery system. These dynamics fuel an urgent call to action for Massachusetts to grow and support a workforce that can meet the pressing demand for behavioral healthcare in the Commonwealth. Informed by a literature review, the development of an inventory of promising models nationwide, and interviews with local and national stakeholders and experts, this report outlines seven concrete recommendations to expand Massachusetts’ behavioral health workforce, increase its diversity, maximize its potential to meet the needs of all people in the Commonwealth, and strengthen its resilience.

NAMD Federal Policy Brief: Behavioral Health Equity

Over the past decade, there have been alarming increases in behavioral health disparities and overdose data, with Black men and Native American/Alaska Native women now experiencing the highest rates of fatal overdose. The National Association of Medicaid Directors recently published a Federal Policy Brief highlighting actions federal stakeholders can take to enhance behavioral health equity. Recommended actions include providing technical assistance to states on building robust non-licensed workforces (e.g., peer support workers and community health workers); supporting states in the development of crisis response systems; and the creation of an option for states to provide Medicaid coverage up to 90 days pre-release, which would help ensure access to behavioral health services during re-entry. The brief also provides examples of efforts states have already launched to address disparities in behavioral healthcare.

State updates: AL, KS, MA, MN, NE, NV, NJ, NM & OR

  • Alabama – The Alabama Department of Health is partnering with Count the Kicks, an evidence-based stillbirth prevention campaign, to educate and empower expectant parents about the importance of paying attention to their baby’s movements in the third trimester. Count the Kicks helps improve birth outcomes by teaching expectant parents the method for and importance of monitoring their baby’s movements during the third trimester of pregnancy.
  • Kansas – Governor Laura Kelly announced that her administration has begun distributing $51 million in bonuses to home and community-based services direct care workers. The Kansas Department for Aging and Disability Services is disbursing the funds as one-time payments to the state’s three Managed Care Organizations (MCOs). MCOs will then disburse the funds to providers who will pay bonuses to their direct support staff no later than March 30, 2023. 
  • Massachusetts – The Baker-Polito administration received federal approval to expand and extend its Medicaid section 1115 waiver through December 2027. The demonstration approved by CMS supports integrated, outcomes-based care for MassHealth’s two million members and brings a new focus on advancing health equity by closing disparities in quality and access. The demonstration also focuses on investing in primary, behavioral and pediatric healthcare.
  • Minnesota – The Minnesota Department of Human Services announced that ten service providers will share approximately $2.9 million in grants to support people with disabilities to live in their communities and access resources, including mental health resources. The grants recognize efforts to strengthen the direct care workforce and improve access to culturally and linguistically responsive services.
  • Nebraska – The Nebraska Department of Health and Human Services (DHHS) selected three health plans to provide healthcare services for Nebraskans in Heritage Health, its Medicaid managed care program: Molina Healthcare of Nebraska, Nebraska Total Care, and UnitedHealth Care of the Midlands. In evaluating the proposals, DHHS considered stakeholder input from several listening sessions conducted earlier this year and will continue to meet with members of the community across Nebraska both in-person and online to answer questions and adjust plans as needed.
  • Nevada – The Nevada Department of Health and Human Services announced that the state’s public option plan could generate $300 to $400 million in savings over five years and nearly $1 billion by year 10. Most of the projected savings could be passed back to Nevada through a federal waiver that Nevada Medicaid intends to submit for approval by March of next year. The public option, which will be available on the Exchange in 2026, is expected to reduce premium costs and increase competition.
  • New Jersey – In an effort to ensure better outcomes for defendants with serious mental health needs who are on pretrial monitoring, Human Services Commissioner Sarah Adelman announced a new pilot program in Camden, Essex and Middlesex counties to identify and connect these individuals to mental health treatment and other vital social services. The mental health diversion program is voluntary, and will provide support and connect individuals on pretrial monitoring to critical mental health and co-occurring mental illness and substance use disorder treatment, housing, medical and other essential social service supports.
  • New Mexico – Governor Michelle Lujan Grisham joined officials from the University of New Mexico and local elected officials to break ground on the new Behavioral Health Crisis Center, expanding access to psychiatric and behavioral healthcare for New Mexicans. The crisis center will expand existing programs and address discontinuities in the metro area’s current behavioral health services, providing access to and expanding capacity for both lower acuity and higher acuity patients to form a comprehensive continuum of care for New Mexicans.
  • Oregon – CMS approved a new section 1115 demonstration that will allow the state to address inadequate food, housing and other root-cause issues that lead to poor health. As part of the agreement, the federal government also approved expanded Oregon Health Plan coverage for young children, as well as extended eligibility for youth and adults. Children determined eligible for Medicaid will stay continuously enrolled until they turn six years old, without their families needing to renew their coverage.