On January 15, 2022, health insurers will be subject to new federal requirements to cover and waive cost-sharing for over-the-counter diagnostic tests for COVID-19 for the duration of the federal public health emergency. Past federal guidance required insurers to fully cover COVID-19 tests, but allowed them to require enrollees to first obtain a health professional’s determination that a test is medically necessary. The new requirements, published January 10, enable consumers to obtain the tests directly from pharmacies or online retailers without being seen by a health professional. With case rates surging and the costs of over-the-counter COVID-19 tests ranging from $14 to $34, this new benefit should provide significant financial relief to privately insured individuals. This expert perspective focuses on key provisions of the new coverage requirements as well as health equity considerations and implications for state insurance regulators.
Promising Approaches to Reducing Disparities in Birth-Related Health Outcomes in Medicaid
Disparities in birth-related health outcomes are rooted in structural racism and the related policies and practices that result in inequitable distribution of social and economic resources. Research estimates that more than one half of cases of maternal mortality and severe maternal morbidity (SMM) are preventable, and birth-related mortality rates among Black, American Indian, and Alaska Native people are two to three times the rate of White people.
The brief focuses specifically on actions Medicaid agencies can pursue through their managed care programs or directly with provider organizations to promote health equity and improve outcomes. It highlights state interventions and collaborations that demonstrate promise in reducing disparities and begin to center equity in birth-related health policies, including: Virginia, which is integrating and enrolling doula providers and services into Medicaid managed care and streamlining the credentialing process for doulas; North Carolina, which has nearly 10 years’ experience with a pregnancy medical home model of care; and Colorado, which will require hospitals that provide labor and delivery services and participate in a Medicaid performance-based incentive program to begin reporting on their plans for reducing peripartum racial and ethnic disparities.