While efforts to reduce the spread of COVID-19 have been difficult in all environments, the conditions for those working in agricultural production raise additional challenges. Migrant and seasonal farmworkers, many of whom travel as crops ripen throughout the spring and summer, live and work under conditions that even before COVID-19 posed risks to their safety and wellbeing. This expert perspective  examines approaches to addressing the particular risks of COVID-19 faced by farmworkers, provides a survey of state and local policies and outlines some key themes and recommendations for policymakers as they work to support agricultural workers and stem the spread of COVID-19.

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.

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As a condition of receiving enhanced federal funding under the Families First Coronavirus Response Act (FFCRA), states are prohibited from terminating individuals enrolled in Medicaid as of March 18, 2020, or determined eligible on or after that date. These continuous coverage requirements run through the end of the month of the public health emergency (PHE), which was recently extended to October 22, 2020. Absent a further extension of the PHE, states have three months to implement a plan for unwinding the FCCRA continuous coverage requirements which are otherwise set to terminate on October 31, 2020. States will also need to identify which newly obtained eligibility and enrollment flexibilities they would like to make permanent beyond the termination of the PHE–especially in the context of emerging information that suggests that the duration of COVID-19 pandemic may extend well into 2021.