Jan, 17, 2025

State Health Updates

  • Arizona – The Arizona Health Care Cost Containment System received CMS approval to provide reentry services to incarcerated individuals as part of its 1115 demonstration waiver. 
  • California – The Department of Health Care Services (DHCS) published quality ratings for Medi-Cal managed care plans (MCP) and county behavioral health plans. Monetary sanctions are being imposed on MCPs that did not meet or exceed the established minimum performance levels, meaning the plans failed to provide members with a level of care that reached the quality standards established by DHCS. These actions are the result of the MCP contract, effective January 1, 2024, which strengthened quality and health equity requirements for MCPs.
  • Colorado – HHS and the U.S. Department of Treasury announced that the Colorado Division of Insurance (DOI) will receive $339 million in pass-through funding for the state’s section 1332 waiver. Additionally, DOI is highlighting recent findings from a report that determined that the addition of Colorado Option plans to the state’s individual market led to premium reductions of over $100, even for non-option plans. 
  • Illinois
  • Maryland – HHS approved Maryland’s section 1332 waiver application, permitting all Maryland residents, regardless of immigration status to enroll in qualified health plans and qualified dental plans through the Maryland Health Connection, the state’s official health insurance Marketplace.
  • Michigan
  • Mississippi – The Mississippi Division of Medicaid is seeking applications for its new Beneficiary Advisory Council (BAC) to advise the state regarding their experience with program matters related to policy and effective administration of the Medicaid program. SHVS has created template materials designed to support state agencies in recruiting members for the BAC. States can customize the content of the materials, which include a recruitment flyer, template social media graphics, core messages, website copy, and newsletter copy.
  • Nevada – HHS approved Nevada’s section 1332 waiver application, approving the state to sell public option plans, known as Battle Born State Plans (BBSPs), through the state’s Exchange. Under state law, BBSPs are required to reduce premiums by certain targets, including by at least 3% in 2026 and 15% by 2029. The state’s waiver also includes implementation of a premium relief program using reinsurance.
  • New Mexico
  • New York – HHS approved an extension of New York’s section 1332 waiver for an additional year through plan year 2029. As a reminder, SHVS published a state spotlight, New York’s Essential Plan Expansion: A Novel Use of Section 1332 Waiver Authority, which highlights the program to provide premium-free coverage with minimal cost-sharing for individuals with incomes up to 250% of the federal poverty level, including DACA recipients.
  • North Carolina – Governor Josh Stein announced an executive order to protect women’s reproductive freedom. The executive order directs cabinet agencies to safeguard medical privacy, ensures women receive accurate information about their pregnancies, and protects doctors providing lawful reproductive healthcare.
  • North Dakota – North Dakota Health and Human Services (HHS) announced it is accepting applications for three student loan repayment programs for qualifying health, behavioral health and dental professionals. HHS is working to recruit and retain healthcare providers, especially in underserved and rural areas.
  • Oregon – The Oregon Health Authority has awarded $23 million to the nine federally recognized tribes of Oregon and 34 local organizations to repair and rehabilitate homes of low-income residents to eliminate risks to residents’ health. Improved housing conditions for low-income families can prevent illness and reduce their healthcare costs, improve safety, conserve natural resources and reduce energy costs for occupants.
  • Tennessee – TennCare, Tennessee’s Medicaid program, announced the awarding of grants to ten psychiatric hospitals across the state. Each hospital will receive $1.5 million annually for two years to support infrastructure improvements, workforce development, and enhanced clinical services to better care for child, adolescent, and adult TennCare members. The funding is provided through the state’s TennCare III Medicaid waiver. 
  • Washington  
    • The Washington State Health Care Authority (HCA) launched a new birth doula benefit on January 1, 2025. Birth doulas in Washington can now get reimbursed for services provided to Medicaid enrollees. The benefit launch follows a joint statewide recommendation for doula services from HCA and the Department of Health.
    • Governor Bob Ferguson signed an executive order directing the Department of Health to convene a roundtable of medical providers, reproductive health experts and policymakers to recommend strategies for protecting reproductive freedom in the state.