Issue Briefs | Apr 12, 2019

Addressing Social Factors That Affect Health: Emerging Trends and Leading Edge Practices in Medicaid

Jocelyn Guyer, Patricia Boozang, and Bardia Nabet, Manatt Health

Medicaid programs are increasingly considering how best to address social factors, such as housing, healthy food, and economic security, that can affect health and medical expenditures. Often referred to as social determinants of health (SDOH), these factors are significant drivers of population health outcomes. While states historically have had some experience tackling such issues for specialized, high-need populations, they are now confronting whether, and how, Medicaid should address SDOH for a broader population of Medicaid enrollees in order to achieve better health outcomes. This issue brief explores the “next generation” practices that states are deploying to address social factors using Medicaid 1115 waivers and managed care contracts, as well as the specific steps states can take to implement these practices.

The State Health Policy Highlight, Leading Edge Practices in Medicaid for Addressing Social Factors that Affect Health, summarizes the next generation practices analyzed in more detail in the issue brief for those readers looking for a quick overview.


Expert Perspectives

November 18, 2019

Standardizing Health Plan Benefit Design: Opportunities and Implications for States

Sabrina Corlette, Georgetown University Center on Health Insurance Reforms

In 2019, the Washington legislature enacted a bill requiring insurers on the state’s health insurance exchange to offer plans with standardized benefit designs, beginning in 2021. Colorado and Maryland are considering similar requirements. As these and other states consider the option of standardized health plans, they can benefit from the experiences of California, the District of Columbia (D.C.), Connecticut, Massachusetts, New York, Oregon, and Vermont, all of which require insurers to offer standardized benefit designs. This Expert Perspective outlines benefits and risks of plan standardization, and raises critical questions that states will need to consider, and offers a decision roadmap for states implementing a standardized benefit design requirement.

January 13, 2020

More States Looking to Section 1332 Waivers

In the absence of federal legislation, states are actively seeking tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states to stabilize their health insurance marketplace. SHVS is tracking state activity and has many resources, including a template, for states interested in pursuing a Section 1332 waiver.

More information

October 18, 2019

New Policy Regarding Uninsured Noncitizens

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.