• States Actions For Expanding Access to Care
• Tax Credits Support Older Adults and High Premium States
• Medicaid Opportunities to Support Youth Exiting Incarceration
• CMS Recognizes ADHD Awareness Month
• State updates: AZ, CA, DE, MA, MI, MT, NE, NJ, NY, OR & RI

 

States Actions For Expanding Access to Care
Last week, State Health and Value Strategies (SHVS) published the latest post in our States of Innovation series. The series highlights what states are working on to achieve better, more affordable and more equitable health for all. This States of Innovation profiles state activity in September, which included states taking action on healthcare affordability, expanding access to care, and health equity.

 

Tax Credits Support Older Adults and High Premium States
The enhanced premium tax credits (PTC) under the American Rescue Plan Act and extended through 2025 by the Inflation Reduction Act substantially increased the subsidies available to buy Marketplace insurance and extended PTC eligibility to people with incomes above 400% of the federal poverty level (FPL). As a result, enrollment steadily increased by 5 million people, 31%, during the 2024 open enrollment period. A report published by the Urban Institute examines the expected distribution of enhanced PTCs among nonelderly people with incomes over 400% FPL. If the enhanced PTCs expire, many older Marketplace enrollees in high-premium states could be forced out of coverage and older couples would face very high out-of-pocket premiums.

 

Medicaid Opportunities to Support Youth Exiting Incarceration
Youth incarceration and justice system involvement exacerbate unmet health and wellbeing needs, creating a cycle of reincarceration, lack of care, and poor health outcomes. A report from the Center for Health Care Strategies provides guidance for states on leveraging Medicaid to improve transitions from incarceration for youth, examines the health and wellbeing needs of youth who are incarcerated, and outlines new federal requirements and Medicaid opportunities. Drawing from a national scan and stakeholder interviews, the report highlights best practices and practical steps for implementation, with an emphasis on youth and family involvement, cross-system collaboration, community partnerships, and expanded services outside of the justice system.

 

CMS Recognizes ADHD Awareness Month
CMS announced the release of the 2024 Medicaid & Children’s Health Insurance Program (CHIP) Beneficiaries at a Glance: Attention-Deficit/Hyperactivity Disorder (ADHD) Infographic in recognition of ADHD awareness month. The infographic provides an overview of the prevalence of ADHD among children enrolled in Medicaid and CHIP, characteristics of enrollees with ADHD, prevalence of common co-occurring health conditions, and utilization of treatment services.

State updates: AZ, CA, DE, MA, MI, MT, NE, NJ, NY, OR & RI

• Arizona – The Arizona Health Care Cost Containment System (AHCCCS) officially launched its Housing and Health Opportunities (H2O) program. The initiative aims to expand housing services for specific AHCCCS members experiencing homelessness. Starting October 1, the H2O program will focus on AHCCCS members with a Serious Mental Illness designation who are also experiencing homelessness or housing instability and have an identified chronic health condition or experienced justice involvement within 90 days.
• California
  • Governor Gavin Newsom announced he signed SB 729 which requires large group healthcare service plan contracts and disability insurance policies to provide coverage for the diagnosis and treatment of infertility and fertility services, including in vitro fertilization.
  • Governor Newsom also signed legislation to increase youth access to healthy foods. The bill package includes AB 2316, which will prohibit California schools from serving and selling foods containing synthetic food dye additives that have been linked to health harms in children, and AB 660, which will standardize quality and safety date labels on food products to create clarity and consistency and better inform consumers in order to significantly reduce food waste in the state.
• Delaware – Governor John Carney signed a package of bills aimed at the long-term sustainability of state retiree healthcare benefits. The legislation increases funding for the state’s Other Post Employment Benefits Trust Fund, which is the long-term vehicle for pre-funding retiree healthcare.
• Massachusetts – Governor Maura Healey announced the appointment of Michael T. Caljouw as Commissioner of the Division of Insurance (DOI). DOI is responsible for overseeing and monitoring an approximately $70 billion industry with more than 1,400 licensed insurance companies and approximately 200,000 individual insurance producers licensed to do business in Massachusetts.
• Michigan – The state submitted a request for a new Medicaid section 1115 demonstration entitled “Reentry Services Demonstration.” The demonstration includes coverage for certain pre-release services to eligible individuals who are incarcerated in state prisons, local county jails, and/or juvenile facilities and who are returning to the community.
• Montana – Governor Greg Gianforte announced an investment of up to $2.5 million to support rural counties and tribal communities as they design and implement targeted, locally-developed solutions to behavioral health needs within their communities. The investment represents the next allocation of $300 million in funding secured by the governor last year to reform and improve Montana’s behavioral health and developmental disabilities services systems.
• Nebraska – The Division of Developmental Disabilities (DDD) at the Department of Health and Human Services announced live listening sessions with Director Tony Green. DDD is transitioning from waitlisting individuals with intellectual or developmental disabilities (IDD) for services to a new approach that will provide individuals with IDD access to specialized services when services are needed. The listening sessions are an opportunity to hear updates from the state about this transition and an opportunity to provide stakeholder feedback. 
• New Jersey – Governor Phil Murphy announced the allocation of more than $25 million from New Jersey’s Opioid Recovery and Remediation Fund to support efforts tackling the opioid crisis, including expanding legal services for those in recovery, enhancing youth substance-use treatment and prevention, and boosting emergency response efforts. The newly allocated funding builds upon more than $95 million in opioid settlement spending announced earlier this year.
• New York
  • The state announced the approval of an amendment to its section 1332 waiver that will result in out-of-pocket savings of $307 million for 117,000 New Yorkers in 2025.
  • Governor Kathy Hochul signed legislation to support maternal and women’s health. S.201/A2656 permits pregnant individuals to enroll in health insurance at any time without penalty; S.1965-A/A.3865-A requires commercial insurers to cover prenatal vitamins when prescribed by a practitioner; S.6674-A/A.7790-A expands insurance coverage requirements for human donor milk to outpatient settings, and S.2465C/A.1696C requires individual, group, and non-profit health insurance plans to cover breast cancer screening and diagnostic imaging.
• Oregon – New data from Oregon Health Authority (OHA) estimates that 97% of Oregonians have health coverage, the highest recorded insured rate in the state’s history. Health insurance coverage numbers are sourced from OHA’s Oregon Health Insurance Survey, which collects data on how many Oregonians are covered by health insurance statewide, and gathers information about medical bills, medical debt, and the ability to get healthcare.
• Rhode Island – Analysis of the latest Rhode Island Health Information Survey conducted on behalf of HealthSource RI, the state’s official health insurance Marketplace, shows that 2.2% of Rhode Islanders are estimated to be uninsured, a reduction from 2.9% when the study was last conducted in 2022.