This toolkit provides a communications planning guide designed to support state Medicaid agencies as they prepare for the upcoming end of the continuous coverage requirement. It outlines phases of planning to organize state efforts.
Medicaid agencies are required to send written notices to enrollees as they begin their redetermination process after the continuous coverage requirement ends. This document contains both English and Spanish template notices designed for use by state Medicaid agencies in their efforts to communicate with enrollees. State Medicaid agencies can customize these documents by editing them to input their state seal or agency logo and other state-specific information. These notices incorporate recommendations from the Centers for Medicare & Medicaid Services and reflect insights from qualitative testing with Medicaid enrollees during focus groups in February 2022.
As of January 1, 2022, a new federal law, the No Surprises Act, is in effect to protect consumers from surprise medical bills for out-of-network care. Some states have laws that already protect some consumers from surprise medical bills, depending on the type of health insurance they have. The federal law applies to all states, extends protections, and offers protections to many more people, including those with employer-sponsored health insurance. This toolkit includes suggested template resources to use in communicating with consumers about the No Surprises Act.
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.
State Health and Value Strategies, in partnership with Health Equity Solutions, created the Health Equity Language Guide for State Officials which is comprised of three tools to help state officials with the language they use to discuss and write about race and health equity. The Guide includes definitions and explanations of words and phrases, how to think about their usage, and examples of how they might be applied.
Medicaid and CHIP Coverage of COVID-19 Vaccine and Treatment: A Roadmap for State Action During and After the Public Health Emergency
Since the early days of the COVID-19 pandemic, the federal government has required states to cover COVID-19 vaccines and treatments for certain eligibility groups under Medicaid and CHIP. Congress significantly enhanced those coverage requirements with the American Rescue Plan Act (ARP) of 2021. This toolkit provides a roadmap for states to identify the types of Medicaid and CHIP policy changes that may be needed to ensure compliance with ARP’s requirements for coverage of COVID-19 vaccines and treatment.
The Internal Revenue Service (IRS) has now released more information about how consumers can receive relief from repayment of excess advance premium tax credits for 2020 under the American Rescue Plan. The information is directly relevant to many 2020 marketplace consumers. While this provision will have a positive impact on marketplace consumers, it could also create confusion given the timing and will require some quick communications. Several state-based marketplaces (SBMs) have expressed interest in language that can be used to provide consumers with information about this new tax relief. State Health and Value Strategies has developed the following template language that SBMs can adapt and use in consumer-facing communications.
On March 11, President Biden signed an approximately $1.9 trillion COVID-19 relief bill—the American Rescue Plan Act of 2021 (“the American Rescue Plan,” ARPA). The American Rescue Plan includes myriad health care provisions, focused primarily in two areas: first, it provides funding the Biden administration requested to carry out its COVID-19 response plans; second, it enacts significant but largely temporary coverage policies. Although all health care coverage provisions of the bill are temporary, many will have a lasting impact. This timeline provides the start and end dates for key health care provisions to help states plan for implementation and future policymaking.
Many states are experiencing budget shortfalls due to the COVID-19 induced recession. Since Medicaid accounts for a significant portion of states’ budgets, states often look to the Medicaid program for savings. Since the Great Recession, states have invested in initiatives that can improve care and also lower costs—such as improving coordination of behavioral health and physical health services, making home and community-based options more available to those who might otherwise go into nursing homes, addressing social drivers of health, and lowering pharmacy costs. Not all of these initiatives can generate short-term savings, but they offer other actions that states facing budget shortfalls may take to achieve savings. This toolkit outlines state options to address Medicaid spending without harming enrollee health and provider stability and access to care.
Coronavirus (COVID-19) Unwinding Federal Medicaid Flexibilities: Issues and Considerations for States
States quickly mobilized to implement emergency federal authorities (e.g., Section 1135 waivers, 1915(c) Waiver Appendix K, emergency Section 1115 waivers) and state-level regulatory flexibilities to respond to the COVID-19 pandemic; now they must determine which flexibilities to scale back or sustain, taking into account fiscal implications. The interaction of the stimulus package dates, the Public Health Emergency, and the President’s National Emergency Declaration, among other factors, are complex, and states are actively grappling with decision making regarding which flexibilities they need and want to keep, and how. This Excel workbook is intended to serve as a tool for states as they strategize and plan for the next phase of the COVID-19 pandemic. Specifically, states can utilize this template to conduct both a primary analysis as they determine which flexibilities to unwind or maintain and a secondary analysis to plan for operational and implementation implications. The workbook has been updated to reflect the renewal of the Public Health Emergency as of October 2, 2020.