September 20 Update

In This Week’s Update:

  • Health Equity Implications of PHE Unwinding
  • State Updates: CA, CO, KS, LA, MA, ME, MN, NC, NJ, NM, NY, PA, OR and UT
  • SEP Enrollment Report
  • Medicaid’s Role in Back to School
  • Oral Health and Health Equity 

 

 

Health Equity Implications of PHE Unwinding

An analysis published by the Urban Institute projects that 15 million people could lose Medicaid coverage when the public health emergency (PHE) ends and states are no longer subject to the continuous coverage requirement in the Families First Coronavirus Response Act. 

 

In light of the potentially seismic shift in Medicaid enrollment, a new expert perspective published by State Health and Value Strategies underscores the imperative for states to center health equity as they plan for the end of the PHE given that Black, Latino/a, and other people of color are most at risk of coverage loss. The expert perspective highlights strategies states can implement to ensure that the end of the PHE does not exacerbate already widespread racial and ethnic disparities in our health care system.

 

State Health and Value Strategies also released an expert perspective exploring how state Medicaid managed care programs and health plans can work collaboratively to increase COVID-19 vaccination rates for the more than 55 million Medicaid enrollees in comprehensive managed care plans.

 

State Updates

 

  • California – Covered California announced that executive director Peter Lee has informed the board that he will leave the organization in early 2022. He has served as Covered California’s first and only executive director, helping launch the exchange in 2012 and leading the organization that has provided millions of Californians with access to affordable, quality health coverage. 
  • Colorado – The Department of Health Care Policy & Financing released a report titled the Health First Colorado Maternity Report. Health First Colorado, Colorado’s Medicaid program, is the primary source of health care coverage for more than 40 percent of births in the state. The report identifies numerous data points and key findings impacting maternal care and outcomes among Health First Colorado members ranging from the importance of prenatal and behavioral health care to a number of risk factors leading to poor outcomes.
  • Kansas
    • Governor Laura Kelly announced the launch of the Pandemic Assistance & Vaccine Equity Grants (PAVE) program. The PAVE program provides an additional funding opportunity to local organizations’ vaccine efforts. The program is specifically dedicated to reaching high-risk, vulnerable communities disproportionately affected by the pandemic, including underserved populations such as racial and ethnic minorities and rural communities. Organizations can apply for grants up to $10,000 to support vaccination efforts.
    • Governor Laura Kelly also announced that Dollar General has joined Dillons Health as part of a new vaccine incentive program to encourage vaccinations and mitigate the spread of COVID-19. All newly vaccinated Kansans 12 years of age and older are eligible to receive $50 per dose, $100 total, at select Dollar General locations. Vaccines will be administered in mobile units in the parking lots of select Dollar General locations.
  • Louisiana – The Louisiana Department of Health is inviting all health care providers to offer input about the state’s current health care technology landscape by participating in the final Louisiana Health IT Environmental Scan (eScan) survey. Provider feedback will be used in determining future policy initiatives related to health information technology. The eScan survey is designed to help Louisiana finalize its State Medicaid Health IT Plan update.
  • Maine – The Mills administration announced that it will distribute $146 million in state and federal funding to Maine nursing facilities, residential care facilities, adult family care homes, and hospitals to support workforce recruitment and retention efforts as they grapple with workforce shortages driven by the COVID-19 pandemic. The Maine Department of Health and Human Services (DHHS) will begin to distribute $123 million in funding, which includes $30 million in general fund dollars authorized through the biennial budget Governor Mills signed into law, to nursing facilities, residential care facilities, and adult family care homes. The funds can be used by long-term care facilities to help address workforce issues by retaining current staff or hiring new vaccinated staff.
  • Massachusetts – The Massachusetts Health Connector, the state-based marketplace, released a new report that provides background on the ConnectorCare program and details the financial structure, administration, cost, and individual and family-level impact of their state-level cost sharing subsidy.
  • Minnesota – Governor Tim Walz announced the launch of a new program offering $100 on-site incentives for COVID-19 vaccines at community vaccination clinics around the state. Participating organizations will offer incentives worth $100 for a completed vaccine series. This program is designed to give organizations flexibility to determine which incentives would most resonate with the local communities they serve. While many will offer Visa gift cards, organizations participating in the program are already planning to tailor their incentives to their communities, with some offering grocery store vouchers, Target gift cards, or culturally specific food items
  • New Jersey – First Lady Tammy Murphy and the New Jersey Department of Health released the third New Jersey Report Card of Hospital Maternity Care that includes interactive data on hospital-specific and statewide surgical births, complication rates and severe maternal birth complications. The report card, which captures the most updated data available from 2019, illustrates improved Cesarean delivery rates which dropped from 34.4 percent to 33.3 percent. However, disparities persist among Black and Hispanic mothers in New Jersey. The rate for birth complications were more than double for non-Hispanic Black mothers than non-Hispanic White mothers. Non-Hispanic Black mothers had the highest rate of severe maternal morbidity with transfusion at a rate of 35.6 per 1,000 delivery hospitalizations, while the rate for non-Hispanic White mothers was the lowest at 13.6 per 1,000 delivery hospitalizations.
  • New Mexico
    • The New Mexico Human Services Department’s Behavioral Health Services Division and Office of Substance Abuse Prevention announced the launch of a new Spanish language campaign to combat opioid misuse in Hispanic communities. An expansion of the state’s successful “Dose of Reality” campaign, “¡El Opio Drama!” includes a six-part series of animated 30-second telenovela-style programming aimed at bridging multi-generational gaps within Spanish speaking households.
    • The New Mexico Primary Care Council announced its mission, vision, and goals to change primary care in New Mexico. The Council was established during the 2021 legislative session to increase access to primary care, improve the quality of primary care services, address the shortage of primary care providers, and reduce overall health care costs. It consists of 22 members representing state agencies, federally qualified health centers, providers, and other healthcare stakeholders.
  • New York
    • NY State of Health, the state’s official state-based marketplace, released a status report on the implementation of both the American Rescue Plan Act and 2021 enhancements to New York’s Essential Plan that increase the affordability and accessibility of Marketplace coverage. This new report, Health Insurance Coverage Update, shows that as of August 31, more than 6.3 million individuals—or one in three New Yorkers—are enrolled in health coverage through the Marketplace. Enrollment has increased across all marketplace programs since April 2021 when the state began implementing these changes.
    • Governor Kathy Hochul announced new efforts to increase COVID-19 vaccinations and prepare for booster shots upon FDA approval. To continue to support vaccinating school-aged New Yorkers, 125 free tickets to the upcoming Governors Ball Music Festival are available to individuals who receive their first vaccine dose at a #VaxtoSchool pop-up location through this new incentive program. The governor also directed the State Department of Health to authorize basic emergency medical technicians (EMTs) to administer the COVID-19 vaccine – adding more than 2,000 fully trained vaccinators back into the state’s program. An additional 50,000 basic EMTs will be able to receive the required training in order to help administer the COVID-19 vaccine and booster doses.
  • North Carolina – Healthier Together, a public-private partnership between the North Carolina Department of Health and Human Services and NC Counts Coalition, released the second round of funding of up to $500,000 for community-based organizations to apply for grants to help North Carolina achieve its goal of delivering equitable access to COVID-19 vaccines. Grants will range from $10,000–$25,000 each (or up to $60,000 for collaborative proposals) and will be awarded to organizations supporting North Carolina communities that experience health inequities, with a focus on ensuring Black/African-American, American Indian/Alaskan Native, Latino(a)/Hispanic, Asian/Pacific Islander and high-poverty and low-wealth communities are able to access COVID-19 vaccines.
  • Pennsylvania – The Pennsylvania Department of Health Acting Physician General Dr. Denise Johnson and the Children’s Hospital of Philadelphia Director of the Vaccine Education Center and Professor of Pediatrics Dr. Paul Offit developed a video resource for Pennsylvanians answering questions about vaccine safety. This video resource can be viewed on Facebook or PAcast.
  • Oregon – The Department of Consumer and Business Services announced that 22,743 people enrolled in health coverage during the COVID-19 special enrollment period from April 1 to August 15, 2021. Additionally, of the Oregonians already enrolled, 72,355 saw an average reduction of 46 percent in monthly premium after financial help due to the American Rescue Plan expansion of financial help.
  • Utah – The Utah Department of Health added new color-coded information to the school tab of the COVID-19 data dashboard to make it easier to see which schools are approaching a Test to Stay event. During a Test to Stay event, schools are legally required to conduct a testing event of all students.

 

Final 2021 Special Enrollment Period Report & Medicaid Enrollment Snapshot

A new report released by the Department of Health and Human Services shows that more than 2.8 million people newly gained access to affordable health care under the Biden-Harris administration through the 2021 Special Enrollment Period on HealthCare.gov and State-Based Marketplaces. The American Rescue Plan’s expanded premium tax credits reduced premiums, increased savings, and provided consumers access to quality, affordable health care coverage through the Marketplaces With the gains made during the SEP, there are now a record-breaking 12.2 million people enrolled in the federal and state Marketplaces. Additionally, the report documents that as of April 2021 over 82.3 million people were enrolled in Medicaid and the Children’s Health Insurance Program.

 

Children’s Health: Medicaid’s Opportunity to Support Child and School Success

The National Association of Medicaid Directors published a blog post authored by Gretchen Hammer, NAMD’s Senior Strategic Advisor and former Medicaid Director for Colorado, that explores five opportunities for Medicaid to support child health and wellbeing as kids head back to school. As children return to school and hopefully back to being connected to the social experiences and health services that can support their healthy development, states will need to leverage Medicaid and CHIP to deliver on one of the core promises of the program: access to services and supports for children and families to help children thrive. The blog post outlines five key opportunities for state Medicaid programs to support healthy development and school success that are drawn from a series of Medicaid Forward Executive Working Groups convened by NAMD over the last year.

 

Oral Health and Health Equity

The National Institute for Health Care Management Foundation published an infographic that highlights the state of oral health in the United States and strategies to support oral health equity. Gum disease remains one of the most prevalent chronic diseases in the United States with 46 percent of adults over 30 showing symptoms. Although significant improvements have been made to improve oral health in America, many people still experience barriers to preventive or essential dental care. Black Americans, Latinos, and Native Americans, as well as low-income populations, children and pregnant women are at greater risk of oral health diseases. The disparities experienced by these populations have only been exacerbated by the pandemic. The infographic highlights the challenges to achieving optimal oral health and identifies opportunities for advancing health equity moving forward.