Federal Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts Effective and End Dates
To help states respond to the ongoing coronavirus (COVID-19) pandemic, the White House, the U.S. Department of Health and Human Services, and the Centers for Medicare & Medicaid Services have invoked their emergency powers to authorize temporary flexibilities in Medicaid and the Children’s Health Insurance Program. Congress’s legislative relief packages have provided additional federal support for state Medicaid programs, subject to certain conditions. The timeframes for these emergency measures are summarized in the chart, including the effective dates and expiration timelines dictated by law or agency guidance. The chart also includes current end dates, which are subject to change as federal and state officials take actions to renew or terminate particular authorities.
On Monday, November 1 State Health and Value Strategies is hosting a webinar that will review steps states can take to integrate health equity into their Medicaid managed care programs. Medicaid’s role in providing healthcare coverage to individuals who experience economic and social disadvantage is leading many states to integrate health equity into their population health management strategies, focusing specific attention on reducing health disparities and addressing conditions that create health inequities. The webinar will profile the recently published Promoting Health Equity in Medicaid Managed Care: A Guide for States, a practical guide that offers a series of concrete actions state Medicaid agencies can implement internally and with their contracted health plans in pursuit of health equity. During the webinar, experts from Bailit Health will review the three sections of the Guide and facilitate a discussion with state officials.
Supporting Health Equity and Affordable Health Coverage for Immigrant Populations: State-Funded Affordable Coverage Programs for Immigrants
Access to affordable health coverage and healthcare for immigrant populations in the U.S. is critical to advancing health equity and reducing health disparities. This issue brief—the first in a series “Supporting Health Equity and Affordable Health Coverage for Immigrant Populations”—provides an overview of the national immigrant health coverage landscape and offers considerations for policymakers related to state-funded affordable coverage programs for low-income individuals who do not qualify for subsidized health insurance under the ACA or other public programs due to immigration status.
COVID-19, the resulting behavioral health crisis (including those related to mental health and substance use disorders), and calls for law enforcement reform related to behavioral health crisis response have heightened the urgency among federal, state, and local policymakers to expand access to behavioral health crisis services. Recently, the federal government has provided new funding opportunities to states to improve access to behavioral health crisis services, including mobile crisis services. As states review the opportunities available to begin, enhance, or expand mobile crisis intervention services under the American Rescue Plan Act of 2021, policymakers may further consider a hybrid funding model that provides mobile crisis providers with a consistent and steady stream of funding to ensure they are able to maintain 24/7 availability and respond in a timely manner to all individuals in crisis, regardless of insurance status. Such a new model for funding mobile crisis services could also be designed to hold payers accountable for covering mobile crisis services when their enrolled members use this essential resource. This issue brief presents a sustainable, hybrid coverage and funding approach for mobile crisis services.
Collection of Sexual Orientation and Gender Identity (SOGI) Data: Considerations for Medicaid and Spotlight on Oregon
Thirteen million people identify as part of a sexual or gender minority (SGM) in the United States, and an estimated 1.17 million of those SGM adults (age 18-64 old) have Medicaid as their primary source of health insurance. Although there has been increasing recognition over the last decade that sexual orientation and gender identity (SOGI) are important determinants of health, the recent coronavirus (COVID-19) crisis has amplified the stark health disparities that many vulnerable populations face. Despite gaps and inconsistencies in state and federal reporting on COVID-19, data continues to show that Black, Indigenous, and other people of color (BIPOC) have been disproportionately impacted by both higher risks of infection and poorer health outcomes. However, health-related data about SGM populations is particularly scarce. This brief documents how information describing SGM populations is currently collected at the federal level and in Medicaid. The brief also spotlights Oregon’s recent efforts to improve the collection of SOGI data, and present several issues that states should consider as they look to improve their collection of SOGI data in Medicaid.
On Wednesday, October 6 State Health and Value Strategies hosted a webinar that provided an overview of eligibility standards for evacuees and strategies that states can deploy to expeditiously enroll people into health coverage in order to access care. Tens of thousands of Afghans who fled the Taliban are awaiting resettlement, with many having already arrived in the U.S. living on military bases and being processed in several states. During the webinar, experts from Manatt Health reviewed new CMS guidance released on September 27, 2021 to help states understand what health coverage options are available to Afghan evacuees.
Promoting Health Equity in Medicaid Managed Care: A Guide for States describes recommended process steps for states to integrate a focus on health equity in their Medicaid managed care programs. It offers a series of concrete steps to be more intentional about advancing health equity in Medicaid, and specifically through Medicaid managed care programs. The guide focuses on the internal agency commitments and changes that are necessary to address systemic barriers to accessing high quality health care and improving health outcomes, particularly among populations that experience persistent health inequities. It is organized into three primary sections, each containing specific actions for Medicaid agencies.
This document provides excerpts of health disparities and health equity language from Medicaid managed care (MMC) contracts and requests for proposals (RFPs) from 15 states and the District of Columbia as well as the contract for California’s state-based marketplace, Covered California. The criteria for inclusion in this compendium were contracts and RFPs that explicitly addressed health disparities and/or health equity. Website links to the full contracts are included where available.