September 26 Update

In This Week’s Update:

  • CDC Data Shows More Than 80% of Pregnancy-Related Deaths are Preventable 

  • Health Insurance Coverage Estimates from the 2021 ACS and CPS

  • The Future of Aging Policy: A Snapshot of State Priorities

  • How Changing the Marketplace Coverage Benchmark Could Impact Affordability

  • State updates: AZ, MI, NC, NJ, NV, OH, OK, OR & RI

CDC Data Shows More Than 80% of Pregnancy-Related Deaths are Preventable 

Last week, the Centers for Disease Control and Prevention (CDC) released data which shows that more than 80% of pregnancy-related deaths in the U.S. are preventable. The data, collected from Maternal Mortality Review Committees in 36 states between 2017 and 2019, found mental health, including suicide and substance use disorder, was the leading underlying cause of death in 23% of cases. More than half of pregnancy-related deaths occurred between one week and one year after delivery. The data also reveal chilling disparities—American Indian and Alaska Native people suffered the most preventable deaths, and a full 93% of the total deaths in these groups were considered avoidable. Cardiac and coronary conditions were the leading underlying cause of death among non-Hispanic Black people, who also suffer hugely disproportionate rates of deadly pregnancy complications.

As a reminder, SHVS has published several resources related to improving maternal health outcomes, including an issue brief on the American Rescue Plan Act’s option to extend postpartum coverage. Another issue brief focuses specifically on actions Medicaid agencies can pursue through their managed care programs or directly with provider organizations to promote health equity and improve birth-related health outcomes. Most recently, SHVS published an issue brief which reviews proactive strategies that states can deploy to support postpartum individuals in maintaining health coverage and access to care when the Medicaid continuous coverage guarantee ends and beyond. 

An Annual Conversation with the U.S. Census Bureau: Health Insurance Coverage Estimates from the 2021 ACS and CPS

State Health Access Data Assistance Center (SHADAC) will host a one hour webinar on Thursday, September 29, 2022 that will provide an overview of 2021 health insurance coverage estimates from two key, large-scale federal data sources: the American Community Survey (ACS) and the Current Population Survey (CPS) Annual Social and Economic Supplement. This webinar will examine the new estimates at both the national and state levels, as well as by coverage type, with technical insight from experts at the U.S. Census Bureau, which administers both the ACS and CPS, and from SHADAC researchers. Attendees will learn about the new 2021 national and state coverage estimates; when to use which estimates from which survey; how to access the estimates via Census reports and the website; and how to access state-level estimates from the ACS using SHADAC resources. Register here to attend.

The Future of Aging Policy: A Snapshot of State Priorities

With a projected population of adults age 65 and older to reach 80.8 million by 2040, the health and well-being of older adults—and the service systems that support them—will become even more imperative. To identify emerging state aging policy priorities, the National Academy for State Health Policy conducted a series of key informant interviews with a wide range of state officials, including health and human services secretaries/commissioners, Medicaid directors, aging and disability directors, and legislators. They come from nine geographically and politically diverse states: Arizona, Arkansas, Hawaii, Louisiana, Massachusetts, Michigan, Montana, New Mexico, and North Dakota. Although each state has its own unique challenges, key themes emerged from the conversations, including: the long-term services and supports workforce, promising practices in home and community-based services, the reconceptualization of nursing homes and assisted living facility service models, and the embedding of social determinants of health in service systems to address the well-being of older adults. The full report is available here.

How Changing the Marketplace Coverage Benchmark Could Impact Affordability

The affordability of healthcare is a pressing concern for many people with commercial health insurance plans, both those obtained through employers and through the Affordable Care Act (ACA) marketplaces. One proposal to reduce high out-of-pocket costs in plans sold through the ACA marketplaces is to change the plan category used as the benchmark for determining the tax credit. A switch in the benchmark plan from silver to gold would mean a greater share of enrollees’ health costs would be covered. A new Commonwealth Fund issue brief analyzes how changing the benchmark plan to gold would potentially affect deductibles and out-of-pocket limits and compares new potential costs to those in employer-sponsored plans. The analysis finds that changing the benchmark to gold would lower the national median deductible for individual coverage from $5,000 to $1,450, based on 2022 marketplace data. This latter amount is similar to the median deductible in employer plans. The national median out-of-pocket maximum in lower-cost gold plans, $7,500, is lower than silver plans but still much higher than employer plans.

State Updates: 

  • Arizona – Jami Snyder, Director of the Arizona Health Care Cost Containment System, received the 2022 HIE Excellence Leadership Award from Contexture, Arizona’s health information exchange, for outstanding leadership in the health information technology area. The award, bestowed during the 15th Annual Arizona HIE Summit & Trade Show, recognizes Snyder for advancing technological solutions aimed at improving quality and patient experience while lowering costs.

  • Michigan

    • Governor Gretchen Whitmer announced the expansion of access to birth control, allowing pharmacists to partner with doctors to directly prescribe hormonal birth control. This action offers easier access to birth control and provides greater freedom for family planning.

    • The Michigan Department of Health and Human Services issued an invitation to the public to attend a virtual meeting on October 3 regarding the list of prescription drugs covered under Michigan’s Medicaid health plans. The purpose of the meeting is to provide an annual forum for the public, stakeholders and interested parties to comment on the prescription list. This forum is in addition to the quarterly written public comment periods.

  • New Jersey – The Murphy Administration announced the addition of a human health supplement to its New Jersey Scientific Report on Climate Change. This addendum will provide information for people, businesses, and government entities across the state to better understand how climate change will impact human health and communities.

  • Nevada – Governor Steve Sisolak announced the launch of a digital discount card for prescription drugs, which will help Nevadans save up to 80% on certain medications. All Nevadans will be able to enroll for free for the discount card, regardless of age, income, or citizenship.

  • North Carolina – CMS approved the extension of Medicaid and CHIP coverage for 12 months after pregnancy in North Carolina. As a result, up to an additional 28,000 people will now be eligible for Medicaid or CHIP for a full year after pregnancy in North Carolina. With this approval, in combination with previously approved state extensions, an estimated 361,000 Americans annually in 24 states and D.C. are eligible for 12 months of postpartum coverage.

  • Ohio – The Ohio Department of Medicaid launched an online behavioral health tool that provides families, teachers, and healthcare providers with resources to navigate children’s behavioral health needs. The content was developed by a panel of clinical childhood behavioral health experts.

  • Oklahoma – A new report from CMS ranked Oklahoma as the top state in the nation for Medicaid application and eligibility processing speed. According to the report, Oklahoma was the only state to process and conduct 100% of applications in less than 24 hours during the first three months of 2022. The Oklahoma Health Care Authority processed nearly 59,000 applications during the reported timeframe.

  • Oregon

    • The Oregon Health Authority (OHA) released an updated report on the progress of behavioral health investments in Oregon. According to the Behavioral Health Investment Report, as of mid-September, OHA has spent or obligated $845 million of the $1.35 billion the Oregon Legislature appropriated during the 2021-2023 biennium, to transform the state’s behavioral health system. In early 2023, state health officials will release additional funds to support mobile crisis services, expand supportive housing for people in substance use treatment and increase rates for behavioral health programs. New rates require federal approval, which is pending.

    • The OHA Ombuds Program, which serves as the advocate for Oregon Health Plan (OHP) members, released a new report detailing top concerns from members of OHP during 2021. Established by legislation, the Ombuds Program provides recommendations and additional oversight internally to OHA Medicaid programs and externally to Medicaid contractors and is independent of Medicaid program implementation, operations or compliance. The report summarizes four areas of significant member concern: OHP member enrollment and member-centered transitions across services and benefits; care coordination improvements; language access and equity-centered approaches; mental health and substance use disorder priorities and existing gaps.

  • Rhode Island – The Office of the Health Insurance Commissioner has approved commercial health insurance premiums for 2023, with modifications that will save Rhode Islanders $22,880,000 in 2023 compared to what commercial insurers requested in their rate filings.