On March 4^th, Judy Heumann, lifelong leader disability rights advocate, passed away. The following is an excerpt from a tribute written by the Consortium for Constituents with Disabilities (CCD):

Judy’s time as a counselor at Camp Jened, a summer camp for disabled youth, and the lives of fellow counselors and attendees is the subject of the award-winning documentary, Crip Camp. Judy hosted a podcast, The Huemann Perspective, and published her memoir, Being Huemann: An Unrepentant Memoir of a Disability Rights Activist and a Young Adult version, Rolling Warrior.

The HELP Committee is looking to identify bipartisan solutions to address our nation’s healthcare workforce shortages and develop these ideas into legislation. As a first step, the Senate Committee on Health, Education, Labor, and Pensions held a hearing on February 16th, “Examining Health Care Workforce Shortages: Where Do We Go From Here?” The hearing looked to address the causes of the current healthcare workforce shortages, and to look for potential solutions. Now the HELP Committee is requesting input from all stakeholders to better understand the drivers of healthcare workforce shortages and hear ideas on potential solutions. Comments and suggestions can be submitted to [email protected] until March 20^th.

On January 26^th, Senator Bob Casey (D-PA) introduced the Better Care Better Jobs Act (S.100). The bill is originally cosponsored by 39 Democratic Senators. The bill will:

Congresswoman Jan Schakowsky (IL-09), a Chief Deputy Whip and Ranking Member on the Innovation, Data, and Commerce Subcommittee of the Energy and Commerce Committee, led 32 of her colleagues in reintroducing the bipartisan Medical Device Nonvisual Accessibility Act (H.R. 4853). This bill would ensure that home-use medical devices are accessible to blind and low vision Americans across the country.

The Medical Device Nonvisual Accessibility Act calls on the U.S. Food and Drug Administration (FDA) to create and enforce nonvisual accessibility standards for home-use medical devices, so that devices are fully accessible to blind or low-vision persons, out of the box. The bill also requires the FDA to consult with the disability community and manufacturers throughout the process. Read the full press release here.

According to Reuters news, House Republicans are eyeing $150 billion in spending cuts that reflect a hardline drive to target education, healthcare and housing - particularly efforts to address racial inequities that conservatives classify as "woke" - as they push forward in talks on the federal debt ceiling. Here are Chairman Arrington’s remarks from Feb. 9 announcement of framework.

How would the Center for Renewing America budget plan cut Medicaid?

Read this Georgetown Center for Children and Families blog here to find out.

Read more in this this Center on Budget and Policy Priorities blog Congressional Republicans’ Plans are Likely to Cut Health Coverage.

Georgetown Center for Children and Families has been updating their 50-state tracker with new information, including revised state unwinding plans and state renewal reports that were submitted to CMS.

To locate the tracker and read a Say Ahhh blog, click here.

The National Association of Medicaid Directors has laid out a framework that outlines phases of the unwinding. Medicaid’s partners, including policymakers, health plans, providers, community-based organizations and others, will play a critical role in the effort to redetermine eligibility for all 90 million people on the program. NAMD’s framework will help Medicaid’s partners anticipate the arc of this effort. The framework breaks down the unwinding into three phases: forming and storming, implementation and course correction, and understanding the new normal. Read more here.   

The long-expected return to Medicaid eligibility re-determinations and renewals, referred to as the “Medicaid unwinding,” has begun. Over the next 14 months, Medicaid agencies must assess the eligibility of over 90 million enrollees, roughly 18 million of whom will be terminated from Medicaid or the Children’s Health Insurance Program (CHIP). A good many of these individuals will be eligible for either employer-sponsored insurance or a subsidized plan on the health insurance Marketplaces.

This SHVS expert perspective provides a checklist of actions state-based marketplaces (SBMs) and state insurance departments (DOIs) can take, if they haven’t already, to reduce gaps in coverage and minimize disruptions in care. Many are designed to be temporary and will be critical to helping people navigate an unprecedented period of disruption. Other actions involve policies or operational improvements that could reap long-term benefits by mitigating risks inherent in Medicaid-Marketplace “churn.” You can find the full article here.

The recorded session of Resources for Navigators and Assisters: A Guide for Medicaid Unwinding Transitions to Private Health Insurance, hosted by the Georgetown University Center on Health Insurance Reforms (CHIR) and Georgetown University Center for Children and Families (CCF) is available here, and you can access the webinar slides here.

A new KFF analysis estimates that enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) will have grown by 23.3 million enrollees, to nearly 95 million, by the end of March. That is when the federal continuous enrollment provision expires, and states can resume disenrollments, which have been paused since February 2020. Millions of beneficiaries are expected to be disenrolled over the next year, and the new estimates illustrate the extent to which enrollment could decline and who will be most affected. Over half of the 23.3 million enrollment increase is among low-income adults under age 65 (56%), and nearly one-third is among children. It is expected that the groups that experienced the most growth due to the continuous enrollment provision—ACA expansion adults, other adults, and children—will see the largest enrollment declines.

The U.S. Department of Health and Human Services, through the Office for Civil Rights (OCR), announced the formation of a new Enforcement Division, Policy Division, and Strategic Planning Division. As HHS’s law enforcement agency, OCR enforces 55 civil rights, conscience and privacy statutes— including the Health Insurance Portability and Accountability Act of 1966 (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009— investigates complaints, conducts compliance reviews, develops policy, promulgates regulations, provides technical assistance, and educates the public about federal civil rights, privacy, and conscience laws.

Read the full news release here.

The Case for Inclusion 2023 report, written by United Cerebral Palsy (UCP) and American Network of Community Resources and Options (ANCOR) offers new data assessing how well state programs are supporting people with intellectual and developmental disabilities, plus a policy blueprint with concrete actions lawmakers at all levels of government can take to strengthen access to home- and community-based services. Read the report.

Realizing the importance of fostering policy momentum for direct care workers across the United States, PHI National, an advocacy organization dedicated to quality care through quality jobs, has created a practical resource guide for the direct care workforce for state-level advocates. The resource guide will help state advocates nurture policies that allow direct care workers to thrive and provide access to the quality services and supports to those in need. The guide offers strategies, steps, and key resources learned from PHI’s Essential Jobs, Essential Care initiative to help stakeholders strengthen the direct care workforce. Ideas from other state advocacy experts and published resources are included in online links.

The 2022 earnings reports for the “Big Five”— CVS Health (Aetna), Centene, Elevance Health (formerly Anthem), Molina, and United Health Group—are now in. As expected, combined Medicaid enrollment for the “Big Five” increased during 2022 by 3.3 million to 43.2 million, an increase of 8.2 percent (Table 1). If children are enrolled in “Big Five” MCOs in the same proportion as they are enrolled in Medicaid overall, these companies are stewards for over 16 million children, and, for three of the companies—Centene, Molina, and UnitedHealth Group—combined Medicaid revenues in 2022 were $181.8 billion, an increase of $23.2 billion, or 14.6 percent from 2021. You can read more on the Big Five MCOs as well as details and analysis of the growth here.

Community health workers (CHWs) have played a key role in states’ COVID-19 responses, and federal funding opportunities have expanded the CHW workforce through an infusion of time-limited funds. As states are seeking sustainable financing models and partnerships that offer continued support for the CHW services beyond the COVID-19 pandemic, many are exploring Medicaid reimbursement models. 

Existing approaches include submitting Medicaid state plan amendments (SPAs) or seeking 1115 demonstration waiver authority to reimburse CHW services. A few states are exploring alternative payment models (APMs). APMs can provide an alternative to Medicaid fee-for-service reimbursement that may help incentivize inclusion of CHWs on care teams and better anticipate the types of services CHWs offer. Additional detail about state-specific approaches can be found via NASHP’s 50-state scan or a recent issue brief detailing state approaches to authorizing CHW reimbursement using SPAs.

NASHP regularly convenes state health officials to discuss policy strategies related to financing and infrastructure for the CHW workforce. During a recent virtual meeting focused on alternative payment approaches, Maine state officials detailed how the state intends to use its Primary Care Plus (PCPlus) program to reimburse for CHW services.­

You can read the full interview here.

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Family Voices is a national organization and grassroots network of families and friends of children and youth with special health care needs and disabilities that promotes partnership with families--including those of cultural, linguistic and geographic diversity--in order to improve healthcare services and policies for children.