September 18 Update

In Last Week’s Update:

  • Health Insurance Coverage Data in 2022
  • Navigating Data Challenges to Keep Eligible People on Medicaid
  • Opportunities for States to Lower Drug Costs Across Payers
  • State updates: AZ, CT, DC, ID, IN, ME, MN, OR, PA, VT & WA


Health Insurance Coverage Data in 2022

The U.S. Census Bureau released a report presenting statistics on health insurance coverage in the U.S. in 2022. More people were insured in 2022 than in 2021, and 92.1% of people, or 304 million, had health insurance at some point during the year, representing an increase in the insured rate from 2021 (91.7% or 300.9 million). In 2022, private health insurance coverage continued to be more prevalent than public coverage, at 65.6% and 36.1% respectively. Employment-based insurance was the most common, covering 54.5% of the population for some or all of the calendar year, followed by Medicaid at 18.8% and Medicare at 18.7%. The uninsured rate among working-age adults ages 19 to 64 years old decreased 0.8 percentage points to 10.8% between 2021 and 2022. The U.S. Census Bureau has published other reports and visualizations on health insurance coverage in 2022 here. On Thursday, September 28, the State Health Access Data Assistance Center is hosting a webinar alongside experts from the U.S. Census Bureau on the release of the 2022 health coverage estimates.

Navigating Data Challenges to Keep Eligible People on Medicaid

As of late August, more than 5.4 million people across the country have lost Medicaid coverage through the unwinding—with 74% due to procedural reasons rather than eligibility. How can state agencies help eligible residents stay enrolled while reducing the growing strain on program administrators? Benefits Data Trust (BDT) and the California Department of Health Care Services will host a webinar to discuss their ambassador model for Medicaid outreach and navigating the complexities and opportunities for using data to help eligible families stay covered. BDT previously sat down with Rhode Island to discuss their key tactics around outreach and ex parte renewal processes to help eligible households stay covered.


Opportunities for States to Lower Drug Costs Across Payers

On August 29, CMS announced the first 10 prescription drugs that will be subject to negotiation for Medicare under the Inflation Reduction Act (IRA). A new blog post by the National Academy for State Health Policy (NASHP) discusses how this milestone, and the steps that will follow, present an opportunity for states to leverage Medicare negotiated prices through reference pricing, a strategy outlined in model legislation that NASHP published in 2022. The Congressional Budget Office estimates that the lower drug prices resulting from these negotiations will reduce the federal budget deficit by $25 billion by 2031. Though the IRA applies the negotiated prices of these 10 drugs to Part D purchasers only, policymakers in some states see an opportunity to broaden the benefit of these lower prices to all purchasers in a state.


State updates: AZ, CT, DC, ID, IN, ME, MN, OR, PA, VT & WA

  • Arizona
    • The Arizona Health Care Cost Containment System (AHCCCS) recently launched AHCCCS Connect, a new feature that sends personalized program reminders and updates to Medicaid applicants and members to guide them through initial application during annual renewal. AHCCCS Connect sends texts, automated voice calls, and/or emails to members. New applicants will be automatically be added to AHCCCS Connect when they provide an email address and/or cell phone number and are able to opt out or rejoin at any time.
    • AHCCCS released its fourth monthly Medicaid renewal data dashboard detailing progress since the regular renewal process began on April 1, 2023. The press release notes AHCCCS is conducting ex parte at the individual level. As a reminder, State Health and Value Strategies (SHVS) published an expert perspective summarizing CMS guidance on conducting eligibility determinations at the individual level as well as a diagnostic tool states can use to evaluate their ex parte processes.  
  • Connecticut – Governor Ned Lamont announced the launch date of a prescription drug discount card program, featured in the new SHVS expert perspective, 2023 Legislative Session Health Highlights. The card will enable all residents of the state to receive savings on certain prescription drugs, as a result of Connecticut joining the multi-state consortium known as ArrayRx, which also operates in Nevada, Oregon and Washington. When purchasing prescription drugs, consumers present the card at their pharmacy and they can receive savings of up to 80% on certain medications.
  • District of Columbia – CMS approved a community-based mobile crisis state plan amendment that allows the District of Columbia to create mobile crisis intervention teams to provide Medicaid crisis services. As a reminder, SHVS published an expert perspective on the enhanced payment available through the American Rescue Plan Act (ARP) for community-based mobile crisis services.
  • Idaho – The Idaho Department of Health and Welfare (DHW) announced it has completed its reevaluation of Idaho Medicaid enrollees whose benefits were protected under federal law during the COVID-19 pandemic. In all, DHW staff processed renewals for 153,196 individuals of whom 31,900 were determined eligible and 121,296 were ineligible. Of those who were determined ineligible, 30% obtained coverage through the state’s health insurance Marketplace.
  • Indiana – The Indiana Family and Social Services Administration (FSSA) announced it has achieved a sustained in-state answer rate of more than 90% a year after the launch of the 988 Suicide & Crisis Lifeline in Indiana. FSSA is also launching a public awareness campaign to educate and encourage those experiencing a crisis to call the lifeline. A resource toolkit is accessible in multiple languages and includes a collection of promotional tools to help spread awareness of the lifeline. 
  • Maine – The Maine Department of Health and Human Services announced that Hilary Schneider will be the next director of the Office of the Health Insurance Marketplace, starting September 25. Commissioner Jeanne Lambrew selected Schneider to lead the Office, which runs Maine’s health insurance Marketplace,, following a national search. Congratulations Hilary!
  • Minnesota – The Minnesota Department of Human Services announced that organizations serving people with disabilities and aging populations across Minnesota will receive over $14 million to expand services to diverse communities, rural areas and regional centers. The grants will help organizations improve their capacity to provide home and community-based services for people with disabilities and aging Minnesotans.
  • Oregon – The Oregon Health Authority announced that the Oregon Health Policy Board approved a blueprint for the state’s Basic Health Program (BHP) and the draft plan will be sent to the federal government for review. BHP coverage will be similar to what is offered by the Oregon Health Plan and will be available to adults in the state with household earnings between 138% through 200% of the federal poverty level. The plan will provide comprehensive medical, mental health and dental care to more than 100,000 Oregonians with lower incomes.
  • Pennsylvania – The Shapiro Administration announced that the Department of Human Services will begin updating the data used to set rates for Medicaid home and community-based services for Pennsylvanians with intellectual disabilities and autism.
  • Vermont – CMS approved a postpartum coverage extension for Vermont. This approval marks 36 states, the District of Columbia, and the U.S. Virgin Islands that have extended postpartum Medicaid coverage to a full year. As a reminder, SHVS published an issue brief on the ARP option to extend postpartum coverage.
  • Washington
    •  Washington Medicaid published a flyer on continuous eligibility for children, which includes information such as how long continuous eligibility lasts, who is eligible, and sources for more information.
    • The Office of the Insurance Commissioner announced the approved rate changes for Washington’s 2024 individual health insurance market. Fourteen health insurers have been approved to sell in the individual market with an approved average rate increase of 8.94%.