NEWS & VIEWS

November 7, 2024

Overdose Deaths Are Rising Among Black and Indigenous Americans

The recent decline in overdose deaths hides a tremendous disparity by race: Deaths have fallen only among white people while continuing to rise among people of color, according to a new Stateline analysis of federal data.

Tracie Gardner, co-director of the National Black Harm Reduction Network, said Black and Native people often have trouble navigating white-dominated institutions, including many harm reduction agencies. Such agencies need to have more people of color in leadership positions to gain the trust of Black, Native and other people who use drugs, she said.

The article also notes that American Indian and Native Alaskan numbers may be worse than reported due to misidentification in data collection.

Federal Legislation Update

H.R.9774 - Health Care Affordability Act of 2024 

This bill would increase access to quality, affordable healthcare by extending coverage for millions of uninsured Americans and lowering health insurance premiums for millions more. The bill would expand tax credits for health insurance coverage and includes technical edits to ensure that no household pays above 8.5% of their incomes towards health care premiums.



2025 ISHN Conference Call for Proposals is Open!

The theme, Health at Home & Beyond, acknowledges that home is not limited to a physical dwelling. Young people thrive in spaces of learning, working, playing, and reverence. Home can represent any space where Hoosier kids feel safe, secure, nurtured, and heard. It is incumbent upon the adults in their lives to create those environments. Join this year’s conference to support the next generation of school and health professionals and the children they serve.

The conference is June 9-11, 2025 at Embassy Suites Plainfield. Submission deadline is January 6, 2025.

Experiences of Racism are Detrimental to

Adolescent Health  

The 2023 national Youth Risk Behavior Survey reports that racism is a key driver of health inequities, particularly among adolescents. The survey found that 31.5% of U.S. high school students reported experiencing racism in school, with the highest prevalence among Asian (56.9%), multiracial (48.8%), and Black (45.9%) students, and the lowest among white students (17.3%). Students who experienced racism had a higher prevalence of poor mental health, suicide risk, and substance use compared to those who had not, especially among Black, Hispanic, Asian, and multiracial students. Additionally, suicide risk was over twice as high for students of color who experienced racism. These findings highlight the disproportionate impact of racism on students of color and underscore the need for schools to implement policies and practices to prevent racial discrimination and provide support for affected students. 

Indiana Association of School Nurse Conference: 

IIC Pre-Conference Meeting

School Nurses are invited to join the Indiana Immunization Coalition for a preconference event with speakers, dinner, and hitting golf balls!

The keynote speaker will be Megan Carlson, DrPH, MSN, RN, PPCNP-BC, Director of Health Services, Indianapolis Public Schools. Dr. Carlson will present strategies for promoting vaccines for students, talking with parents to boost vaccine confidence, and the importance of school-based vaccine clinics.

This IN-PERSON meeting is on November 19, 2024 from 5:30-9:30pm at Top Golf Fishers.

Marketplace Open Enrollment

Marketplace open enrollment started November 1, 2024 and will continue through January 15, 2025. Here is a roundup of information and tools.

Outreach and Education Tools and Resources

The Centers for Medicare & Medicaid Services (CMS) invites organizations to become a Champion for Coverage and to actively educate communities about the Marketplace and Medicaid. You do not need to provide enrollment services to sign up.

CMS is once again organizing theme weeks during open enrollment. Each week has a toolkit with talking points as well as social media posts and graphics.

Out2Enroll offers their Open Enrollment 12 (OE12) Social Media Toolkit with key messages, hashtags, key dates, and social media graphics and posts. This and other Open Enrollment resources can be found here. Some of the graphics are available in Spanish. While LGBTQ individuals are the priority population for Out2Enroll, most messages will resonate with other audiences, especially young adults.

Young Invincibles also has an Open Enrollment Toolkit, in English and Spanish, which includes resources, suggested messaging, social media graphics and posts, sample email blasts, and sample fliers. Young adults are their priority population, but most messages will resonate with other audiences.

Other helpful educational pieces include a consumer checklist to Get Ready to Apply for or Re-Enroll and Information on Re-Enrollment.

DACA Eligibility and Resources

As of November 1st, DACA (Deferred Action for Childhood Arrivals) recipients can enroll and receive Advanced Premium Tax Credits (APTC) and Cost Sharing Reductions (CSRs). They can sign up in November for coverage starting in December as a special enrollment or sign up for coverage starting in 2025 as part of Open Enrollment.

• The Centers for Medicare and Medicaid Services (CMS) released a toolkit that includes FAQs, a drop-in article, a fact sheet, social media messages, postcard, and fillable flier.
• Young Invincibles, United We Dream, and the National Immigration Law Center launched a campaign to education DACA recipients of their options.
• State Health & Value Strategies released a report, Reaching DACA Recipients: Resources to Support State Outreach and Education to Drive Healthcare Enrollment. It includes talking points and template resources for social media, text messages and radio.
• Information on what coverage is available depending on immigration status from Beyond the Basics.

Marketplace Subsidies, Credits, and Cost Sharing

The Inflation Reduction Act of 2022 ensured that enhanced Marketplace subsidies would continue through 2025. It also created a special enrollment period (SEP) for individuals with low incomes – between 138% - 150% in Indiana. This SEP is now permanent.

Previously, if a consumer did not reconcile their taxes for one year, they became ineligible for Advanced Premium Tax Credits. This was paused for the 2021 – 2023 tax years. Consumers will now become ineligible for APTC if taxes are not reconciled for two consecutive years.

Consumers eligible for cost sharing reductions who were enrolled in a bronze plan and do not actively select a new plan, will likely be automatically re-enrolled in a silver plan.

What’s New This Year (and a Few Things That Were New Last Year)

The Marketplace application now offers an optional voter registration question which will provide interested consumers with additional information.

HealthCare.gov improvements will help consumers better navigate information on the site. Improvements were also made to make managing accounts and completing applications an easier and better experience.

CMS continues efforts to protect the integrity of the Marketplace and protect consumers from unauthorized enrollments and changes to accounts. CMS’ October 17th press release explains efforts to secure the Marketplace. For additional information for assisters and the public check out:

• Healthcare.gov page on fraud and scams
• Flier on how to protect yourself from fraud

Organizations that are Certified Designated Organizations (CDOs) with CMS should have received an email from cacquestions@cms.hhs.gov about a designated Marketplace Call Center line for Assisters. Assisters are strongly encouraged to use this line to receive efficient service and to help the Marketplace track Assister needs. The email included a 10 digit access code which is usually your organization’s main phone number.

Sources: October webinar from Beyond the Basics, CMS October Open Enrollment Fact Sheet, KFF Policy Watch: Ten Things to Watch for 2025 ACA Open Enrollment, Georgetown University McCourt School of Public Policy Center for Children and Families blog: What’s New for the 2025 Plan Year Open Enrollment

Unwinding

A report from the Urban Institute assesses lessons learned from the Unwinding, the colloquial term for the return to normal Medicaid rules and operations, in eight states where redetermination outcomes for children were favorable. The report found some keys to success included maximizing automated renewals, using multiple methods of communication to obtain updated enrollee contact information, employing strategic and wide-ranging partnerships to inform state communications and outreach to enrollees, and supporting grassroots organizations in their direct assistance efforts. 

Enhanced Premium Tax Credit Resource

The State Marketplace Network has released a comprehensive new resource documenting the impact of enhanced premium tax credits on consumers.

The credits have resulted in more affordable coverage for the 21 million people served by the health insurance marketplaces, including pre-retirees, small business owners, rural communities, and young adults.

The resource features links to fact sheets, reports, analyses, and consumer stories from state-based marketplaces and national experts, all underscoring the critical significance of tax credits for marketplace consumers.

Without Congressional action, the tax credits are set to expire next year.

Preventive Services for Women

A recent survey by KFF found many women are unaware that the Affordable Act requires many of the preventative services important for their health to be covered at no cost to them.

• Annual checkup - 29% of women did not know or believe this is covered with no cost-share.
• Contraception - 57% of women (71% of the uninsured) did not know or believe this is covered with no cost-share.

Under the ACA, most private health plans and Medicaid expansion programs must provide coverage with no cost-sharing for many recommended preventive services that are important to women, including female contraceptives, mammograms, and yearly checkup visits. The lack of knowledge of this benefit may result in fewer women accessing recommended preventive care.

Inaugural National HPV Conference

The Indiana Immunization Coalition is hosting the inaugural National HPV Conference and registration is open!

The goal of this conference is to bring together professionals working in the HPV space in the U.S. to learn and share. While many conferences strive to include HPV as one of many topics, this conference seeks to make HPV the main topic. Attendees will enjoy learning and connecting with peers while forming new ideas and partnerships to strengthen their HPV-related efforts.

The conference will be April 15-17, 2025 at the Hyatt Regency, Indianapolis. For more information, visit National HPV Conference.

Nearly 5,000 more people of color died from overdoses in 2023 than in 2021, while deaths among white people dropped by more than 6,000, according to the analysis of provisional data from the federal Centers for Disease Control and Prevention. (The full article is up in the Policy section.)

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