Strategies for States to Drive Equitable Vaccine Distribution and Administration
Drawing on insights learned through discussions with state officials, informed by grassroots community organization input and a review of the literature, this issue brief outlines key barriers states face in their efforts to increase vaccination rates among BIPOC and highlights strategies states are pursuing in partnership with community-based organizations (CBOs) to address these challenges. This issue brief also considers future phases of the COVID-19 vaccine rollout and planning, including near-term efforts to vaccinate children and adolescents, as well as longer-term opportunities to build sustainable infrastructure and capacity to advance health equity related to the pandemic, emergency preparedness, and beyond within state and local public health and health care delivery systems.
Strategies for States to Drive Equitable Vaccine Distribution and Administration
On Thursday, August 12, State Health and Value Strategies hosted a webinar during which experts from Manatt Health and Health Equity Solutions provided an overview of the strategies states can pursue in partnership with community-based organizations to reduce disparities in COVID-19 vaccine uptake, and in the longer term, to build a more equitable and sustainable public health system. While more than 20 states and the District of Columbia reached the Biden administration’s goal of administering one or more COVID-19 vaccine doses to at least 70 percent of adults by early July, wide variation in vaccination rates persists across communities within these states and among the 30 states still working to reach this goal. This variation in vaccination rates at the community level translates to disparities across racial and ethnic groups, as most states continue to have disparities in vaccination rates between Black, Indigenous and people of color (BIPOC) and white populations. States and their community partners are implementing a broad range of distribution and outreach strategies to improve vaccine equity and are looking to build sustainable infrastructure and capacity to advance health equity within state and local public health and health care delivery systems.
Highlights of the Buying Value Benchmark Repository: Innovative Homegrown Measures
On Tuesday, June 22, State Health and Value Strategies hosted a webinar on innovative measures that states have developed to address their program priorities. States are responsible for ensuring that their Medicaid programs are delivering high-quality, high-value care, but there are not always nationally-endorsed measures focused on states’ areas of interest. The webinar featured state officials from the Oregon Health Authority and Massachusetts Executive Office of Health and Human Services, who discussed their experiences developing and implementing homegrown measures in their state Medicaid programs.
American Rescue Plan’s New State Option for Community-Based Mobile Crisis Interventions
On Monday, June 14, State Health and Value Strategies hosted a webinar during which experts from Manatt Health provided an overview and considerations on the state option to provide community mobile crisis interventions services included in American Rescue Plan. Presenters walked through key questions on the new option, reviewed promising models for crisis mobile intervention services, and shared strategies for equitable design and implementation. The webinar also included a question and answer session during which webinar participants posed their questions to the experts on the line.
Collection of Race, Ethnicity, Language (REL) Data in Medicaid Applications: A 50-state Review of the Current Landscape
This issue brief documents how states are collecting information about race, ethnicity, and language on their Medicaid applications. The information presented here draws from the State Health Access Data Assistance Center’s (SHADAC’s) review of 50 states’ paper Medicaid applications and 33 states’ online Medicaid applications. For this resource, the authors provide an overview of REL data collection standards and examine state Medicaid application’s question structure, answer options, and instructional language. They also provide an overview of the frequency of different iterations of questions and responses and provide state examples to illustrate common and unique data collection practices.
Assessing Enhanced Federal Funding for HCBS Under the American Rescue Plan
The American Rescue Plan Act includes a number of provisions that will significantly impact state and federal health care policies and programs, including enhanced federal funding for state Medicaid spending on home- and community-based services (HCBS). Beginning April 1, 2021 and through March 31, 2022, states will be eligible to receive a 10 percentage point increase in their federal medical assistance percentage (FMAP)—the share of state Medicaid spending that is paid for by the federal government—for specified HCBS. This updated brief describes ARP’s HCBS enhanced FMAP provision, CMS’s recent implementation guidance, and considerations and next steps for state policymakers.
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.
Revisiting the Basic Health Program
This issue brief provides a refresher on the Basic Health Program structure as outlined in the ACA, lessons learned from the two states that have implemented the program to date, and considerations for further evolution of the program under legislative or executive action.
Assessing the Fiscal Impact of Medicaid Expansion Following the Enactment of the American Rescue Plan Act of 2021
A substantial body of evidence indicates that adopting the Medicaid expansion delivers myriad benefits to states and Medicaid enrollees at a modest cost to states. Currently, 12 states have not yet taken up the ACA Medicaid expansion, leaving approximately 2.2 million adults in the so-called “coverage gap” without an affordable source of coverage. The recent enactment of the American Rescue Plan Act of 2021 (ARP) makes the fiscal case for Medicaid expansion even stronger by providing states that implement expansion after the enactment of ARP with a significant increase in Medicaid funding. This issue brief describes the ARP matching rate provision and also assesses its fiscal impact for each of the states that have not yet expanded Medicaid, while comparing the available new federal dollars to the cost of expansion.
Notice Template Regarding Reconciliation Relief under Section 9662 of the American Rescue Plan
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.