State Spotlight: North Carolina’s Comprehensive Medical Debt Relief and Reform Incentive Program
In an innovative, first-of-its kind approach, North Carolina is tackling the issue of medical debt through a comprehensive initiative that pairs immediate relief with long-term reform. By leveraging federal funding through the Medicaid program, hospitals are incentivized to cancel existing medical debt—up to $4 billion for approximately two million low-income North Carolinians—and enact a series of policies to prevent the future accumulation of medical debt. This state spotlight provides an overview of North Carolina’s medical debt relief incentive program, underscores the unique efforts of the state to achieve buy-in from stakeholders, and highlights the opportunity as a model for other states.
State Spotlight: New York’s Essential Plan Expansion: A Novel Use of Section 1332 Waiver Authority
On April 1, 2024, New York began covering residents in a new affordable coverage program made possible with a first-of-its-kind section 1332 waiver, reshaping the insurance market and allowing the state flexibility to design a program with people at the center.
State Spotlight: Massachusetts’ Cutting-Edge Health Equity Initiatives
This state spotlight highlights the investments and efforts that the Commonwealth of Massachusetts is making to promote health equity in and through the state’s Medicaid and Children’s Health Insurance Program (CHIP), otherwise known as MassHealth. With the highest coverage rate in the nation, the Commonwealth of Massachusetts has made great strides in ensuring access to healthcare for low-income residents and is now paving the way to reduce racial and ethnic disparities experienced by Medicaid and CHIP enrollees. As described in the state spotlight, MassHealth’s multi-pronged health equity strategy focuses on five cross-cutting areas: community engagement; social drivers of health; continuous enrollment; perinatal health; and provider and health plan incentives.
State Spotlight: Oklahoma’s Award-Winning Communications Campaign to Promote Medicaid Expansion Enrollment
The Affordable Care Act’s Medicaid expansion allows for the expansion of Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level (FPL) and provides states with an enhanced federal matching rate for their expansion populations. On June 30, 2020, the Oklahoma Medicaid Expansion Initiative, State Question 802, passed by a majority vote to expand Medicaid eligibility to adults ages 19 to 64 whose income is 138% of the FPL or lower. This state spotlight describes the Oklahoma Health Care Authority’s approach to outreach and education in support of overall enrollment goals.
State Spotlight: California’s Landmark Coverage Expansion for Immigrant Populations
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.