All States/Territories

On June 12, the U.S. Department of Health and Human Services (HHS) announced new flexibilities to help keep individuals covered as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals. The new flexibilities were announced in a letter Secretary Becerra sent to the nation’s governors encouraging them to adopt available flexibilities to minimize coverage losses. Building on flexibilities HHS offered to states before renewals resumed, some of the new flexibilities announced include: Allowing managed care plans to assist people with Medicaid with completing their renewal forms, including completing certain parts of the renewal forms on their behalf....

This promising practice profile describes the Rhode Island No Wrong Door system including key partners, the state’s long-term services and supports interagency reform initiative, and the state’s approach to person-centered options counseling. The profile includes links to important resources such as the state’s Person-Centered Options Counseling Operational Manual and the No Wrong Door System Strategic Plan.

MACPAC, the non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP), released its June 2023 Report to Congress on Medicaid and CHIP. The report features the agency’s recommendations in four areas: payment policy for safety net hospitals, integrated care for people who are dually eligible for Medicaid and Medicare, coverage for adults leaving incarceration, and access to Medicaid home- and community-based services (HCBS)...

On June 7, Justice in Aging published an issue brief titled “An Equity Framework for Evaluating and Improving Medicaid Home and Community Based Services.” In recent decades, long-term care has shifted from institutional settings to home and community-integrated settings. While access to HCBS has been steadily increasing over time, systemic inequalities due to racism, sexism, ageism, classism, etc. have led to large disparities in HCBS for diverse communities. This issue brief evaluates several ways in which the current setup of HCBS can cause inequities to arise. This includes program design, provider availability, awareness of HCBS, implicit bias in services, and provision of HCBS...

As reported in the June 14 Health Affairs article, “National Health Expenditure Projections, 2022–31: Growth To Stabilize Once The COVID-19 Public Health Emergency Ends”, healthcare spending is projected to grow 5.4 percent per year, on average, between 2022 and 2031. Growth in Medicare spending is expected to be 8.0 percent in 2023, with Medicare hospital spending growth anticipated at 11 percent this year due to an increase in volume and intensity growth. Among the major payers, Medicare spending is expected to have the highest rate of growth at 7.8 percent per year from 2025 through 2031, compared to Medicaid expenditures at an average of 5.6 percent growth over 2025 through 2031, and private health insurance spending averaging 5.2...

Millions of older adults in the United States classify as sexual and gender minority (SGM). The Aging with Pride initiative is a National Health, Aging, and Sexuality/Gender Study which is funded by the National Institute on Aging (NIA), involving more than 2,400 older adults ranging in age from 50 to more than 100 years old. SGM adults experience prejudice, bias, or discrimination which can be a significant source of stress. These negative life exposures can also affect aging and health and contribute to health disparities in SGM adults. Ultimately, the goal of this Aging in Pride study is to better understand the health, aging, and well-being of SGM adults in midlife and older age.

The Administration for Community Living (ACL) is inviting input on its proposed updates to the regulations governing the Older Americans Act (OAA) program. The proposed rule addresses various emerging issues and seeks to provide clarity on requirements for programs authorized under Titles III (grants to state and community programs on aging), VI (grants to Indian tribes and Native Hawaiian grantees for supportive, nutrition, and caregiver services), and VII (allotments for vulnerable elder rights protection activities) of the OAA. By enhancing support for the national aging services network, the aim of these proposed updates is to improve program implementation and better serve older adults.

The Administration for Community Living (ACL) and Centers for Medicare & Medicaid Services (CMS) announced actions to improve enrollment in the Extra Help with Medicare Prescription Drug Plan Costs program, also known as the Low-Income Subsidy. The Extra Help program provides eligible older adults and individuals with disabilities with help paying for their Medicare Part D prescription drug premiums and cost-sharing. Up to three million older adults and individuals with disabilities are eligible for the Extra Help program but are not enrolled. Actions to increase uptake of the program include targeted efforts to reach those eligible for the program, including individuals living in rural and underserved communities...

On June 8th, CMS announced a new voluntary primary care model called “Making Care Primary (MCP) Model”. The 10.5-year multi-payer model is designed to improve care and strengthen coordination between primary care clinicians, specialists, social service providers, and behavioral health clinicians as well as address individuals’ health-related social needs. CMS is testing the model in eight states— Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington—and will work with these states’ Medicaid agencies to align their programs with the new model in key areas. CMS plans to work with private payers in the future...

Today, the Department of Health and Human Services, through CMS, announced 43 prescription drugs covered under Medicare Part B that may have lower beneficiary coinsurances. From July 1, 2023, through September 30, 2023, some people with Medicare who take these drugs may save between $1 and $449 per average dose, depending on the beneficiary’s coverage. Under the Inflation Reduction Act, signed into law in August 2022, drug companies that raise their drug prices faster than the rate of inflation are required to pay a rebate to Medicare. Starting July 1, 2023, Medicare beneficiaries may pay a lower coinsurance for certain Part B drugs if the drug’s price increased faster than the rate of inflation in a benchmark quarter.