Budget Blog

August 12, 2021 - Health Care Issues Update

By Stacey Mazer posted 08-12-2021 12:00 AM


CMS Releases March 2021 Medicaid and CHIP Data and Enrollment Trends and July Special Enrollment Marketplace Report

The Centers for Medicare & Medicaid Services (CMS) released the March 2021 enrollment trends snapshot report showing enrollment trends from February 2020 to March 2021 for Medicaid and the Children’s Health Insurance Program (CHIP). In March 2021, 81.7 million individuals were enrolled in Medicaid and CHIP with enrollment increasing by 11 million or 15.6 percent since February 2020. Medicaid enrollment increased by 10.8 million or 16.9 percent and CHIP enrollment grew by 174,461 or 2.6 percent. The Medicaid enrollment increases are likely driven by the maintenance-of-effort requirement in the Families First Coronavirus Response Act, according to CMS. The snapshot also captures information on the trend in the number of Medicaid and CHIP applications received by states. The number of Medicaid and CHIP applications submitted directly to states was about 5 percent higher in March 2021 compared to February 2021. Additionally, CMS released the July special enrollment report showing that since February 15, 2021, 1.8 million Americans have signed up on HealthCare.gov, with an additional 723,000 enrolling in coverage through the 15 state-based marketplaces during the special enrollment period that will close on August 15. Data shows that families are seeing average savings of $40 per person per month on premiums due to the American Rescue Plan Act premium credits, and over a third of customers have found coverage for $10 or less per month.


Medicaid Directors Urge CMS to Ensure High Costs of New Alzheimer’s Drug Not Shifted to States

The National Association of Medicaid Directors (NAMD) called on the Centers for Medicare & Medicaid Services (CMS) to act swiftly to resolve the health and budgetary concerns around the approval of a new Alzheimer’s drug, Aduhelm. NAMD noted that in the case of Aduhelm, the federal government is simultaneously approving a new Alzheimer’s drug that is so unproven and expensive that its own Medicare program might refuse to cover it. At the same time, the Medicaid program would be required to cover that same drug in most cases setting up a dire budget situation for states. Based on preliminary cost projections from 19 states, NAMD estimates that, if Medicare chooses not to fully cover this product, total state and federal Medicaid spending on Aduhelm will increase by 250 percent nationally, with spending increases in some states ranging as high as 500 percent.


CMS Revokes Medicaid Work Requirements in Three Additional States

The Centers for Medicare & Medicaid Services (CMS) sent letters to state officials in Ohio, South Carolina, and Utah revoking its approval of Medicaid work requirements. These states had already delayed implementing the work requirements. CMS notes that requiring work as a condition of receiving health care would likely decrease Medicaid enrollment without increasing employment and would be especially harmful during the COVID-19 pandemic.  Of the 12 states originally granted approval of work requirements during the prior administration, only Georgia has not had its waiver formally revoked yet, though work requirements are not currently in operation in the state.


State Survey on Medicaid Home and Community-Based Services

This issue brief by the Kaiser Family Foundation presents early findings from their most recent 50-state survey of Medicaid home and community-based services (HCBS) programs. It focuses on state policies adopted in response to challenges posed by the pandemic, the pandemic’s impact on Medicaid HCBS enrollees and providers, and states’ early plans for the new 10 percentage point temporary increase in federal Medicaid matching funds for HCBS authorized in the American Rescue Plan Act (ARPA). Over half of responding states reported early plans for the new ARPA temporary enhanced federal funds for Medicaid HCBS with the most frequently reported activities being provider payment rate increases and workforce recruitment.


HHS Announces Multiple Awards to Combat Substance Use Disorders, Improve Rural Health

The Department of Health and Human Services (HHS) recently made funding announcements to combat substance use disorders and improve rural health. First, the Health Resources and Services Administration (HRSA) announced the provision of nearly $90 million to help rural communities combat opioid use disorders and other forms of substance use disorders (SUD) and to improve access to maternal and obstetrics care. In addition, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a total of $13.3 million in first-year funding that supports direct treatment services for people with substance use disorders and wraparound supports for their loved ones. Lists of recipients can be found here.


Medicaid Authorities and Options to Address Social Determinants of Health

This issue brief by the Kaiser Family Foundation describes options and federal Medicaid authorities states may use to address enrollees’ social determinants of health and provides state examples, including initiatives launched in response to the COVID-19 pandemic. The issue brief focuses on state-driven Medicaid efforts to address social determinants for nonelderly enrollees who do not meet functional status or health need criteria for home and community-based services (HCBS) programs. Although federal Medicaid rules prohibit expenditures for most non-medical services, state Medicaid programs have been developing strategies to identify and address enrollee social needs both within and outside of managed care. The Centers for Medicare & Medicaid Services (CMS) released guidance in January 2021 for states about opportunities to use Medicaid and CHIP to address social determinants of health.