Budget Blog

June 24, 2021 - Health Care Issues Update

By Stacey Mazer posted 06-24-2021 12:18 PM


NASBO Releases Spring Fiscal Survey of States with Medicaid Feature

Today, NASBO released the Spring 2021 Fiscal Survey of States, which includes a feature on Medicaid (see Chapter 4, pages 82-105 of the full report). The Medicaid feature includes information on Medicaid spending and enrollment, programmatic changes and trends to both enhance the program and contain costs, changes attributable to the Affordable Care Act (ACA) including expenditures for Medicaid expansion, and Medicaid spending trends and budget pressures. For fiscal 2021, total Medicaid spending is estimated to increase by 12.5 percent, with general funds increasing by 2.7 percent, other state funds increasing by 13.4 percent, and federal funds increasing by 15.9 percent. Total Medicaid spending in governors’ proposed budgets for fiscal 2022 is estimated to increase 5.2 percent with spending from general funds increasing by 12.5 percent, other state funds increasing by 4.8 percent, and federal funds increasing by 2.8 percent over the fiscal 2021 amounts. States assumed different dates for the expiration of the increased Federal Medical Assistance Percentage (FMAP) in their proposed budgets, which affects overall spending and spending from fund sources. States were asked to identify issues and trends that are affecting their Medicaid spending. The impact of COVID-19 on Medicaid is at the forefront of state concerns, especially the end of the increased FMAP tied to the declaration of a public health emergency. States further noted concerns about increased enrollment driven by both the rise in the number of those unemployed and the continuous eligibility requirements that are linked to the increase in the FMAP. States also mentioned pharmacy costs, particularly for specialty drugs, overall enrollment, and utilization trends for long-term care.


CMS Releases January 2021 Medicaid and CHIP Data and Enrollment Trend Snapshot Showing Continued Rise in Enrollment

The Centers for Medicare & Medicaid Services (CMS) released the December 2020 and January 2021 enrollment trends snapshot report showing enrollment trends from February 2020 to January 2021.  Medicaid and Children’s Health Insurance Program (CHIP) enrollment increased by 9.9 million or 13.9 percent, with Medicaid enrollment increasing by 9.7 million or 15.2 percent and CHIP enrollment growing by 123,596 or 1.9 percent. The snapshot also captures information on the trend in the number of Medicaid and CHIP applications received by states. Additionally, the Kaiser Family Foundation’s data note looks at national and state-by-state Medicaid and CHIP enrollment data through January 2021, as states were still experiencing the health and economic effects of the coronavirus pandemic. Increases in enrollment reflect changes in the economy and provisions in the Families First Coronavirus Response Act that require states to ensure continuous coverage to current Medicaid enrollees to access a temporary increase in the Medicaid match rates.


CMS Announces $20 Million in American Rescue Plan Funding to Improve Access to State-Based Marketplace Coverage

The Centers for Medicare & Medicaid Services (CMS) announced $20 million in American Rescue Plan Act of 2021 (ARPA) funding to support state-based marketplaces to improve access to affordable, comprehensive health insurance coverage for consumers in their states. States can apply for funding to help modernize or update their systems, programs, or technology to comply with federal marketplace requirements, including the recent provisions of ARPA that increased the financial assistance available to certain consumers. Applications are due July 20, 2021.


CDC and HHS Award $200 Million for Disease Intervention Specialist Workforce

The Centers for Disease Control and Prevention (CDC) and Department of Health and Human Services (HHS) awarded 59 jurisdictions $200 million to bolster support and enhance the disease intervention specialists workforce. These awards represent the initial funding of the $1.13 billion investment being made over the next five years, consistent with the American Rescue Plan Act of 2021 (ARPA).


HHS Announces $80 Million Funding Opportunity for Public Health IT

The Department of Health and Human Services (HHS) announced the development of an $80 million Public Health Informatics and Technology Workforce Development Program to strengthen public health informatics and data science. The program aims to train more than 4,000 individuals over a four-year period through an interdisciplinary approach in public health informatics and technology and bolster representation of underrepresented communities in the public health IT workforce. Funding is from the American Rescue Plan Act of 2021 (ARPA). The notice of funding opportunity can be found here; applications are due August 11.


National Association of Medicaid Directors Releases Report on Children’s Health

The National Association of Medicaid Directors released a report, Medicaid Forward: Children’s Health, the second in a three-part series that looks at how Medicaid can and will play a critical role in recovering from the pandemic and establishing a new normal for American health care. Recommendations include streamlining eligibility pathways for children, increasing access to health care services that support strong development, and extended coverage for pregnant women to 12-months postpartum.


Key Challenges and Opportunities in Expanding Medicaid Home and Community-Based Services

This paper from the Bipartisan Policy Center discusses the key challenges and opportunities identified by experts in expanding Medicaid Home and Community-Based Services (HCBS), and outlines options for congressional consideration. Some experts indicated that an expansion of HCBS should be done through the Medicare program, rather than Medicaid, and several proposals have been introduced to create a Medicare long-term care benefit.