State Health and Value Strategies (SHVS), in partnership with Manatt Health, Health Equity Solutions, Georgetown’s Center on Health Insurance Reforms (CHIR), the State Health Access Data Assistance Center (SHADAC), Bailit Health, and GMMB, developed this resource page to serve as an accessible “one-stop” source of health equity information for states. This resource is designed to support states seeking to make coverage and essential services available to all of their residents, regardless of where they live, how much money they make, or discrimination they face. SHVS will update this page frequently with new resources as they become available.
With the possibility of a COVID-19 vaccine growing closer, increasing attention is focused on how it may be distributed, a responsibility that will largely fall to state, territorial, and local governments. Preventing racial disparities in uptake of a COVID-19 vaccine will be important for helping to mitigate the disproportionate impacts of the virus for people of color and preventing widening racial health disparities going forward. Moreover, reaching high vaccination rates across individuals and communities will be key for achieving broader population immunity through a vaccine. This brief provides an overview of barriers to vaccination that disproportionately affect people of color and discusses how current national recommendations and state vaccine allocation plans address racial equity.
The presidential transition and the incoming Biden-Harris administration’s commitment to addressing the equity issues associated withtheCOVID-19pandemicprovide an opportunity to identify programmatic and policy approaches that can ensure the kind of participation in containment and prevention strategies that will address the disproportionate disparities we see every day.
This paper identifies the services that are essential to an equity-centric approach totheCOVID-19pandemic, as well as the infrastructure and workforce needed to ensure these services are available and have an equity focus.It reviews a set of administrative and legislative steps that the new presidential administration can take to strengthen the immediate response to the pandemic and address the long-term health and social needs the pandemic has exacerbated. Finally, it offers a strategy for “building back better” in the long term.
The current public health insurance landscape for postpartum women leaves many new mothers uninsured during the first year after pregnancy, because eligibility for pregnancy-related Medicaid/Children’s Health Insurance Program (CHIP) coverage ends 60 days after pregnancy ends. In this report, we assess how many uninsured new mothers would likely benefit from a 12-month postpartum Medicaid/CHIP extension. Using 2016–18 American Community Survey data and 2020 Medicaid/CHIP eligibility rules, we find that approximately 28 percent of the nation’s estimated 440,000 women uninsured during the first year postpartum, or 123,000 new mothers annually, would likely be newly eligible for Medicaid/CHIP if pregnancy-related coverage were extended for 12 months postpartum. An additional 27 percent of uninsured new mothers are likely already eligible for Medicaid but not enrolled, and 15 percent would likely be eligible for subsidized Marketplace coverage. Postpartum extension could help ensure many new mothers’ access to needed health care during the critical postpartum period.
Concerns about maternal morbidity and mortality in the US have focused attention on uninsurance during the first year after pregnancy and fueled efforts to improve access to postpartum coverage. In this report, we assess the current public health insurance landscape for pregnant and postpartum women, including Medicaid, the Children’s Health Insurance Program (CHIP), and subsidized Marketplace coverage; recently proposed state and federal legislation to extend postpartum coverage; and how much such legislation could expand the coverage landscape for new mothers. Under current subsidized coverage options, gaps remain for many women, and extending pregnancy-related Medicaid/CHIP coverage from 60 days to 12 months postpartum could considerably expand new mothers’ coverage options in most states and promote continuous care during the postpartum period.
The current public health insurance landscape for postpartum women leaves many new mothers uninsured during the first year after pregnancy, because eligibility for pregnancy-related Medicaid/Children’s Health Insurance Program (CHIP) coverage ends 60 days after pregnancy ends. In this report, we assess how many uninsured new mothers would likely benefit from a 12-month postpartum Medicaid/CHIP extension. Using 2016–18 American Community Survey data and 2020 Medicaid/CHIP eligibility rules, we find that approximately 28 percent of the nation’s estimated 440,000 women uninsured during the first year postpartum, or 123,000 new mothers annually, would likely be newly eligible for Medicaid/CHIP if pregnancy-related coverage were extended for 12 months postpartum. An additional 27 percent of uninsured new mothers are likely already eligible for Medicaid but not enrolled, and 15 percent would likely be eligible for subsidized Marketplace coverage. Postpartum extension could help ensure many new mothers’ access to needed health care during the critical postpartum period.
The Public Health Insurance Landscape for Pregnant and Postpartum Women
This paper identifies the services that are essential to an equity-centric approach to the COVID-19 pandemic, as well as the infrastructure and workforce needed to ensure these services are available and have an equity focus. It reviews a set of administrative and legislative steps that the new presidential administration can take to strengthen the immediate response to the pandemic and address the long-term health and social needs the pandemic has exacerbated. Finally, it offers a strategy for “building back better” in the long term.
This brief provides an overview of key issues to consider for reaching noncitizen immigrants as part of COVID-19 vaccination efforts.
Today, House Ways and Means Chairman Richard E. Neal (D-MA) released a staff report, titled “Left Out: Barriers to Health Equity for Rural and Underserved Communities” that analyzes the barriers to health care in underserved communities and discusses the challenges associated with scalable and sustainable solutions. From massive geographic coverage deficiencies to structural environmental factors, the report examines the realities millions of Americans face that adversely affect their health.
A new Health Affairs blog post authored by Dr. Nathan Chomilo, Medical Director for the State of Minnesota’s Medicaid program and a practicing pediatrician and an internal medicine hospitalist with Park Nicollet Health Services/HealthPartners, highlights how racial equity can be built into research and policy and why this is important step as states and policymakers seek to dismantle structure racism in the health care system. Dr. Chomilo notes several examples of how stakeholders can assess research and policy for racial equity at the start. These examples include requiring a racial equity assessment at the start of the development of research proposals aimed at answering policy questions to help ensure investigators have, at the very least, stopped to ask how their work may or may not contribute to structural racism or advance racial justice and improving and standardizing ways to collect race, ethnicity, and language demographic data for not only public payers such as Medicare and Medicaid but all health insurers, social safety-net programs, and education systems.
This infographic explores the history of racial bias and discrimination in health care and during the pandemic, and highlights strategies to address systemic racism and improve health outcomes.
A collection of essays from various authors which is JHPPL’s first effort to make sense of the pandemic as a political, social, and comparative phenomenon that is likely to redefine public health, health policy,and health care politics for years to come.
Blog post that explores health inequities tied to lack of access to energy, water and broadband
CDC released a new study examining the disproportionate impacts of COVID-19 on American Indians and Alaska Natives (AI/AN) in 23 states between January 31 and July 3. The report found:
• The cumulative incidence of laboratory-confirmed COVID-19 cases among AI/AN was 3.5 times that of non-Hispanic whites
• Compared to whites, a higher percentage of cases among AI/AN individuals were in people under 18 years of age (12.9 percent AI/AN; 4.3 percent white)
• A smaller percentage of cases were among AI/AN individuals who are 65 years or older (12.6 percent AI/AN; 28.6 percent white)
Three reports that profile solutions from abroad.
This post will present a framework for understanding health disparities during the COVID-19 pandemic, as well as provide short-term and long-term solutions to reduce these disparities.
Policy makers can help ameliorate disparities by mandating standardized case and fatality reporting requirements and directing public health agencies to investigate why particular populations, including Asian Americans, face a seemingly heightened risk of death from COVID-19.
This memo provides a summary of policy approaches to address the disproportionate impact of COVID-19 on communities of color.
The Health Opportunity and Equity (HOPE) Initiative, funded by the Robert Wood Johnson Foundation, provides an interactive data tool to help the nation and states to move beyond measuring disparities to spur action toward health equity.
This article examines why it is important to go further and examine the root cause of racial disparities in underlying health conditions and COVID-19 outcomes.
Medicaid agencies can leverage existing and new authorities, enabled through recent COVID-19 federal regulatory flexibilities, to develop a broad plan for addressing disparities in the near-and long-term.
Recommendations developed by the Connecticut Health Foundation aimed at ensuring the state’s COVID-19 response reaches those who are most at risk.
COVID-19 has urgently demonstrated that everyone needs to live in safe and healthy communities. The people most affected by COVID-19 are communities of color, people with low income, immigrants, and other underserved groups. These groups are most vulnerable in part because of existing laws and policies that affect the fundamental drivers of health inequities. Communities and local governments that take steps to ensure health, safety, housing, food, and economic stability for all of their residents will be helping to prevent the spread of COVID-19 and laying the groundwork for health equity and prosperity for future generations. To help communities and local governments strengthen their response to COVID-19 and advance health equity, ChangeLab Solutions is publishing a blog series about policies that governments can enact right away.
Opinion piece written by Dr. Richard Besser, President and CEO of the Robert Wood Johnson Foundation and former acting director of the Centers for Disease Control and Prevention.
The Social Interventions Research and Evaluation Network (SIREN) at the University of California San Francisco, is a research organization focused on the intersection of medical and social services. In response to the COVID-19 crisis, SIREN has developed a resource center of sites aggregating data about health equity, policy, and social risk related to the coronavirus and related financial crisis.
Public conversations surrounding COVID-19 health outcomes in Black and Latino communities must address the role of structural racism, including how community trauma, neighborhood disinvestment, and environmental toxins can cause or further exacerbate those conditions, and how these, in turn, are driven by inequities in political power and economic opportunities. This webinar, co-hosted by Families USA and the National Urban League, highlights findings from “The Fierce Urgency of Now: Federal and State Policy Recommendations to Address Health Inequities in the Era of COVID-19”, and discusses how COVID-19 reveals legacies of disinvestment and inequities in communities of color, and how you can take action to organize for justice at the state and federal level.
On August 14, 2019, the Department of Homeland Security (DHS) published a final rule, Inadmissibility on Public Charge Grounds. The rule makes significant changes to the standards DHS will use to determine whether an immigrant is likely to become a “public charge”—a person dependent on the government for support—which will have consequences for certain immigrants’ legal status. This document provides answers to frequently asked questions about whom the rule will impact, what benefits are implicated by the rule, and how the rule might be administered.
In this Expert Perspective, our colleagues at Manatt Health review the Supreme Court’s decisions granting the Administration’s requests to stay preliminary injunctions that had blocked the Department of Homeland Security public charge final rule from taking effect in October 2019.
A report which gives some practical suggestions for public health departments wanting to become equity focused
On October 4, the President issued a proclamation that requires immigrants to show that they have health insurance or can pay medical expenses out of pocket in order to receive a visa. The proclamation will impact individuals applying for a visa with the Department of State (DOS) through consular offices abroad. In this expert perspective, Manatt Health reviews this latest policy regarding uninsured noncitizens and provides their take on implications for states.
On August 12, 2019 the Department of Homeland Security (DHS) issued a final version of its public charge rule which was to go into effect on October 15. The public charge rule will change how DHS determines whether immigrants—when seeking admission to the U.S., an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support). The webinar reviewed the final rule, highlighted changes from the proposed rule, and explored the rule’s potential impacts on consumers, states and providers.
On October 1, the Robert Wood Johnson Foundation’s State Health and Value Strategies program hosted a webinar, facilitated by experts at Manatt Health on the long-anticipated proposed rule released by the Department of Homeland Security (DHS) on September 22. The proposed rule seeks to change how DHS determines whether immigrants—when seeking admission to the United States, an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support). Consequentially, being determined a “public charge” may put immigration status at risk. The webinar reviewed the proposed rule and its potential impacts on consumers, states and providers. Specifically, we highlighted the key ways the proposed rule departs from current guidance, with a particular focus on the implications for Medicaid and other health-related public benefits, and how the proposed rule may impact consumers’ access to certain benefits.