Budget Blog

June 25, 2020 - Health Care Issues Update

By Stacey Mazer posted 06-25-2020 01:40 PM


NASBO Releases Spring Fiscal Survey of States with Medicaid Feature

Today, NASBO released the Spring 2020 Fiscal Survey of States, which includes a feature on Medicaid (see Chapter 4, pages 73-97 of the full report). The Medicaid feature includes information on Medicaid spending and enrollment, programmatic changes and trends, changes attributable to the Affordable Care Act (ACA) including expenditures for Medicaid expansion, and state spending and budget pressures as well as the potential impact of the Centers for Medicare & Medicaid Services (CMS) Medicaid Fiscal Accountability Proposed Rule. As is the case with other data in this survey, the figures for Medicaid do not reflect the impact of COVID-19 that will significantly alter actual fiscal 2020 and fiscal 2021 figures. Before the COVID-19 pandemic, governors’ recommended budgets for fiscal 2021 assumed total Medicaid spending of $681.4 billion with $175.4 billion from general funds, $83 billion from other state funds and $423 billion from federal funds. Total Medicaid spending was estimated to increase 3.4 percent on a median basis with spending from general funds increasing by 4.2 percent, other state funds staying relatively flat, and federal funds increasing by 3.5 percent over the fiscal 2020 amounts. States were asked to identify issues and trends that are affecting their Medicaid spending. Though not reflected in the figures in the report, the impact of COVID-19 on Medicaid is at the forefront of state concerns, specifically the spike in enrollment states are expecting to see due to the rise in the number of those unemployed. States also expressed concern about the potential impact from COVID-19 costs on reimbursement rates for Medicaid providers who have been particularly hard hit during the pandemic. Other concerns were around pharmacy costs, particularly for specialty drugs, overall enrollment and utilization trends such as for elderly and disabled individuals, Medicaid expansion, waivers such as those for home and community-based services, costs related to Medicare, rural hospitals, federal regulations, and behavioral health. Since the onslaught of the COVID-19 pandemic and ensuing economic fallout, states are anticipating increased enrollment in fiscal 2020 and especially in fiscal 2021 as a result of the projected increase in unemployment, expected to be 11.5 percent in 2020 and 9.3 percent in 2021, according to the most recent economic projections by the Congressional Budget Office (CBO) released in May 2020.


HHS Releases Distribution of $10 Billion for Safety Net Hospitals

The Department of Health and Human Services (HHS) recently released a state-by-state distribution of Provider Relief Fund monies to safety net hospitals. A total of $10.2 billion is included in the distribution. Additional information on distributions from the Provider Relief Fund can be found here. HHS also updated the Provider Relief Fund dataset. The data reflect providers that received a payment, have attested to receiving payment, and have agreed to the terms and conditions as of June 22.


Options to Support Medicaid Providers in Response to COVID-19

This brief from the Kaiser Family Foundation provides an overview of how states currently reimburse providers and the challenges for Medicaid providers that have emerged from the pandemic. It presents new data on state actions to date to help bolster Medicaid providers dealing with the effects of COVID-19 and discusses support available for Medicaid providers from the Provider Relief Fund.  


Administration Issues FAQs on Health Care Coverage Including Testing

The Department of Health and Human Services (HHS), Department of Labor (DOL), and the Department of the Treasury released a set of frequently asked questions (FAQs) regarding the requirement for coverage of COVID-19 testing under the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The FAQs address topics including when testing needs to be covered, applicability to self-insured group health plans, and notice requirements. For example, the FAQs state that COVID-19 testing for surveillance or employment purposes are not required to be covered under the Families First Act.


HHS Announces $107 Million in Health Care Workforce Grants

The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced $107.2 million to 310 recipients to increase the health workforce in rural and underserved communities. Recipients across 45 states and U.S. territories received funding to improve the quality, distribution and diversity of health professionals serving across the country. These programs provide financial and professional support to physicians, faculty, dentists, nurses and students as they pursue careers in health care settings. Awardees will be able to develop and retain clinicians in high-need areas to meet health needs of the most disadvantaged communities.


CMS Releases March 2020 Medicaid and CHIP Data

The Centers for Medicare & Medicaid Services (CMS) released the March 2020 monthly report on state Medicaid and Children's Health Insurance Program (CHIP) eligibility and enrollment data. This data reflects a range of indicators related to key application, eligibility, and enrollment processes within the state Medicaid and CHIP agencies. In March 2020, 70.9 million individuals were enrolled in Medicaid and CHIP. Of that total, 64.1 million were enrolled in Medicaid and 6.8 million were enrolled in CHIP.