Collection of Race, Ethnicity, Language (REL) Data on Medicaid Applications: New and Updated Information on Medicaid Data Collection Practices in the States, Territories, and District of Columbia
This issue brief documents how race, ethnicity, and language (REL) data are collected by Medicaid programs in the 50 U.S. states, the District of Columbia, and five U.S. territories. This new brief serves as an update to State Health Access Data Assistance Center’s previous brief, providing up-to-date information on Medicaid REL data collection among the states and extending the analysis to include the District of Columbia and the five territories.
A growing number of states view extending affordable health coverage to lower-income residents, regardless of immigration status, as a critical step towards narrowing the gap in health coverage, advancing health equity, and improving the overall health and well-being of all residents. This state spotlight reviews California’s approach to expanding health coverage to all lower-income residents, regardless of immigration status, in an effort to help the state’s 3.2 million remaining uninsured, of which 65% are undocumented.
This compendium provides information on strategies to improve maternal health outcomes and synthesizes research about the national state-of-play, including state examples, across four domains: maternal health models, quality improvement, workforce and benefits, and eligibility and enrollment/coverage expansion. This resource builds on a September 2022 maternal health roundtable convened by State Health and Value Strategies (SHVS) and Manatt Health with California, Louisiana, Maryland, Minnesota, and Tennessee.
When the federal Medicaid continuous coverage requirement expires, states will redetermine eligibility for nearly all Medicaid enrollees, including roughly 1.7 million people enrolled in a Medicaid or CHIP pregnancy eligibility group. This issue brief 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.
The American Rescue Plan Act of 2021 (ARP) establishes a new state option to extend Medicaid and CHIP coverage for pregnant women for one year following the baby’s birth. ARP’s new state option to extend continuous coverage for one-year postpartum enables states to take a major step towards improving health outcomes for postpartum women and their babies. This issue brief reviews the policy and operational considerations for states who are considering extending postpartum coverage.
The End of the Public Health Emergency Will Prompt Massive Transitions in Health Insurance Coverage: How State Insurance Regulators Can Prepare
Once the public health emergency ends, state Medicaid agencies will need to recommence Medicaid eligibility redeterminations and renewals. As a result, up to 16 million people are projected to lose their Medicaid coverage, and an estimated one-third of these individuals will be eligible for subsidized coverage in the Affordable Care Act (ACA) Marketplaces. Whether a state’s Medicaid agency moves swiftly or slowly to process eligibility redeterminations, the commercial insurance market–and particularly the ACA Marketplaces–could experience a significant growth in enrollment. This issue brief identifies several areas in which state departments of insurance (DOIs) may want to coordinate with other agencies or external stakeholders, issue new regulations or guidance, and establish means for minimizing gaps in coverage or access to services.
On February 17, the Department of Homeland Security (DHS) released its 2022 notice of proposed rulemaking (NPRM) which would largely codify longstanding federal guidance regarding DHS’ authority to refuse a noncitizen’s application for admission or application for visa adjustment (including receipt of a green card) on grounds that they are “likely at any time to become a public charge.” This issue brief provides an overview of key provisions of the 2022 NPRM and includes commentary to describe how the proposed rule differs from the 1999 Field Guidance, as well as how the proposed rule seeks to promote clarity and address the chilling effects caused by elements of the now-repealed 2019 Rule.
Reshaping the Narrative on Public Charge to Reach Immigrant Populations That Need Affordable Health Insurance
Many immigrants and their families are concerned that enrolling in Medicaid/CHIP, Marketplace, and other public health insurance programs will run afoul of public charge rules and jeopardize their immigration status. These fears remain despite the fact that the administration has reinstated longstanding public charge guidance that does not consider the use of Medicaid/CHIP benefits (other than government-funded institutionalization for long-term care) or Marketplace coverage in a public charge determination. This issue brief, the third in a series, Supporting Health Equity and Affordable Health Coverage for Immigrant Populations, provides an overview of the status of the public charge rule and presents strategies to help connect eligible individuals to affordable coverage.
A recognition by leaders and policymakers in many states that longstanding structural racism has caused disproportionate health risks and poorer health outcomes for communities of color is prompting action to prioritize and advance health equity. One key strategy states are using to test new or innovative ideas related to health equity in their Medicaid programs is Section 1115 demonstrations. A new series from State Health and Value Strategies shares strategies for states to consider as they work to advance health equity and address structural racism through Medicaid Section 1115 demonstrations.
Tracking Medicaid Coverage Post the Continuous Coverage Requirement: Using Data Dashboards to Monitor Trends
The Families First Coronavirus Response Act Medicaid “continuous coverage” requirement has allowed people to retain Medicaid coverage and get needed care during the COVID-19 pandemic. When continuous enrollment is discontinued, states will restart eligibility redeterminations, and millions of Medicaid enrollees will be at risk of losing their coverage. The current lack of publicly available and timely Medicaid enrollment, renewal, and disenrollment data will make it difficult to understand exactly who is losing coverage and for what reasons. One effective way to monitor this type of information is through the use of Medicaid enrollment and retention dashboards. This issue brief examines the current status of data collection to assess Medicaid enrollment and retention, summarizes potential forthcoming reporting requirements, and describes some of the best practices states should consider when developing a data dashboard to display this type of information.