State News Roundup - July-August 2022


Report Focusing on Black Alaskans’ Health Describes Challenges that Create Disparities
By Yereth Rosen l Alaska Beacon l July 13, 2022

A report prepared for the Alaska Black Caucus indicates that Black Alaskans face significant health disparities across the state, according to the Alaska Beacon. The report explores access to care and the health status of Black Alaskans and finds that more Black Alaskans reported delaying medical care due to cost than Alaskans of other races. The report is the first known assessment of Black Alaskans’ health status and access to health services. The authors hope that it will serve as a foundation for future health policies to address health disparities in the state.

Alaskans Spend Most on Out-of-Pocket Care than Residents of All Other States
By Emily K. Johnson, et al. l Health Affairs l Aug. 1, 2022

Alaskans spent more out-of-pocket on healthcare than residents of any other state prior to the pandemic, according to a report in Health Affairs. The study demonstrates that out-of-pocket spending represented an estimated 42 percent of healthcare dollars spent in the state in 2019. The analysis also estimated the annual rate of change in healthcare spending increased 3.6 percent per person between 2013 and 2019 in Alaska. The report includes detailed descriptions of state-level spending per person by payer, variation in spending patterns across the states and the impact of Medicaid expansion on state spending.


Closing the Gap: Addressing Disparities and Improving Outcomes for Colorado Medicaid Members
By the Colorado Department of Health Care Policy and Financing | July 1, 2022

Colorado’s Department of Health Care Policy and Financing released its health equity plan for 2022-2023 to apply a health equity lens across its programs and initiatives. The report identifies four initial Medicaid health disparity areas of focus, including: COVID-19 vaccination rates; maternity care; behavioral health; and prevention. Additionally, health equity plans are in all Accountable Care contracts as of July 1, 2022.

Coloradans’ Needs and Experiences Highlight Demand for Culturally Responsive Care
By Colorado Health Institute | July 11, 2022

According to a report by the Colorado Health Institute, there is a distinct need for culturally responsive care in Colorado, which is associated with better health outcomes and more positive experiences within the healthcare system. In 2021, nearly 7 percent of Coloradans reported needing healthcare that responded to at least one unique need, such as language, sexual orientation, culture, disability or experience with trauma. Furthermore, nearly three-quarters of Coloradans who identified a need for culturally responsive care reported that more than one characteristic affected the care they needed. These overlapping experiences and identities affect the type of care people need – one common set of factors that combined to affect Coloradans’ needed healthcare was language, culture and race. Of those who said that the language they speak affected their healthcare needs, 43.5 percent also reported needing culturally responsive care due to their culture and 38.3 percent due to their race. This report suggests that Coloradans are not always receiving care that matches their needs, but that by providing culturally responsive care, the state can increase access and reduce health disparities.  

Investments in Alternative Payment Models in Colorado for Primary Care Increasing
By Martina Dolan | | July 20, 2022

Investments in alternative payment models to increase the use of primary care are increasing across Colorado, reports Alternative payment models as a percent of all medical payments have remained at 44 percent.

Colorado’s State Employee Health Insurance Plan Signed onto the Colorado Purchasing Alliance
By John Ingold | The Colorado Sun | Aug. 22, 2022

Colorado’s state employee health plan has joined the Colorado Purchasing Alliance to provide access to lower prices, reports The Colorado Sun. Under a purchasing alliance, employers band together to negotiate with providers themselves, aiming to drive bargains that insurance companies may not be motivated to seek. The alliance gives consumers access to the Healthcare Bluebook, which allows them to compare the prices and quality ratings of providers, including providers with whom the alliance has negotiated lower-price contracts. Only about two-thirds of Colorado employees have access to the alliance tools and have the option to choose whether or not they want to participate.


Illinois to Require Implicit Bias Awareness Training
By Thomas Sullivan | Policy & Medicine | July 17, 2022

Beginning on Jan. 1, 2023, healthcare professionals in Illinois will need to complete a one-hour course in implicit bias awareness training as part of their required continuing medical education (CME), reports Policy & Medicine. The new law requires these training courses to include, at a minimum, the following topics: an explanation of implicit bias and how it forms and operates; effects of implicit bias and the harm it can cause; and how to recognize, interrupt and mitigate implicit bias. These courses have been added to CME in numerous states for various providers in the hopes that it will help diminish the incidence of implicit bias, increase trust between patients and providers and help increase health equity.


Kansas Healthcare is Saddling People of Color with Debt
By Celia Llopis-Jepsen l KCUR l July 19, 2022

Twenty-nine percent of Kansas adults who live in communities of color have medical debt in collections, reports KCUR. Moreover, communities of color in Kansas struggle much more than people in neighborhoods with similar demographics in other states. Using data from the Urban Institute, reporters at KCUR detail the negative impact that medical debt has on financial viability, home ownership and community prosperity as well as the effect recent insurance premium increases have had on healthcare affordability in the state. The author writes that two-thirds of debt collection lawsuits across the country stem from medical bills, further indicating the value of state-level consumer protections targeting medical debt.


Kentucky Offers Cost-Effective Care Program for Older Adults
By Associated Press | Aug. 19, 2022

Kentucky has unveiled an initiative aimed at providing comprehensive, cost-effective care for people age 55 and older, reports the Associated Press. The program will mostly serve residents who are dually eligible for Medicare and Medicaid and be candidates for long-term care. Those in the program will work with a team of health professionals to receive coordinated care, including primary care, physical therapy and social supports.


New MaineCare Coverage for Federally Non-Qualified Children Under 21 and Pregnant People
By State of Maine Department of Health and Human Services | July 1, 2022

Maine has expanded Medicaid eligibility for children and pregnant people who are ineligible due to immigration status, according to the Department of Health and Human Services. Children under the age of 21 and pregnant people who are eligible for CHIP coverage but not federally qualified for Medicaid benefits due to immigration status—those who immigrated within the last five years or without documentation—but otherwise meet the income requirements are now eligible for full Medicaid benefits.

Maine Announces $1.6M Grant Program to Expand Medical Provider Training in Rural Areas
By the Office of the Governor | July 20, 2022

Maine announced $1.6 million in grant funding to expand opportunities training healthcare professionals and medical providers in rural communities, reports the Office of the Governor. The initiative offers funding to support expansion or development of new medical residency programs in underserved areas and clinical training opportunities for students enrolled in training programs for nursing, behavioral health professionals, pharmacists, physical therapists, physicians, physician assistants, emergency medical services and dentistry. This aims to strengthen Maine’s healthcare workforce, particularly in rural areas.


2021 Health Insurance Survey Reveals Healthcare Affordability Burdens
By Massachusetts Center for Health Information and Analysis | July 2022

Every year, the Massachusetts Health Insurance Survey (MHIS) examines healthcare affordability by asking residents about difficulties paying medical bills, medical debt, the share of family income spent on out-of-pocket costs and unmet healthcare needs due to costs. The 2021 MHIS report notes that, despite high rates of insurance coverage in the state, 41 percent of residents reported that they or their families had healthcare affordability issues in the past 12 months. Furthermore, 13 percent of residents reported having family medical debt–eighty-eight percent of those with family medical debt incurred all of those medical bills while they and their family members had health insurance. Finally, nearly one-third (31%) of residents reported having an unmet healthcare need in their family due to cost in the past 12 months. Although insurance coverage can act as a mitigating force against high healthcare costs and medical debt, it is not a full solution–Massachusetts residents continue to face healthcare affordability burdens even with health insurance.  


Michigan Directs Insurers to Reduce Premium Rates
By the Office of the Governor | Aug. 18, 2022

The Michigan Department of Insurance and Financial Services will require health insurers to reduce previously filed health insurance rates for 2023, according to the Office of the Governor. This is made possible due to additional consumer subsidies made available through the federal Inflation Reduction Act.


Federal Government will Step in to Help Pull Missouri out of Months-Long Medicaid Backlog
By Clara Bates l Missouri Independent l Aug. 9, 2022

Missouri will receive federal support to address Medicaid application delays across the state, reports the Missouri Independent. Missouri residents who are newly eligible for Medicaid following expansion face an average waiting period of 115 days according to data from the Missouri Department of Social Services. The Centers for Medicare and Medicaid Services (CMS) has approved certain strategies to decrease the delays, including allowing the state to fast-track applications received through the federal marketplace and routinely enrolling the parents of children already receiving Medicaid benefits. Enrollment delays may result in negative health outcomes such as delaying needed care and forgoing preventative care altogether, which is explored in more depth in the full article.

New Hampshire

New Hampshire Expands Medicaid to Include Dental Benefits for Adults
By Adam Sexton | WMUR | July 1, 2022

New Hampshire is expanding Medicaid to include dental benefits for adults, reports WMUR, committing to roughly $21 million to get the program up and running for the next three years. Previously, New Hampshire Medicaid only covered emergency dental care, so patients often waited until they had severe problems, increasing costs for the program. Not only is this benefit anticipated to reduce costs, but advocates say that preventive oral care will improve overall health and help recipients maintain employment. Consumer Healthcare Affordability State Surveys in other states have shown that residents across the U.S. frequently go without needed dental care due to cost.

New Jersey

Survey: NJ Voters Frustrated by Rising Healthcare Costs
By Tom Bergeron | ROI NJ | Aug. 1, 2022

New Jerseyans are not happy with the healthcare system–and their biggest complaint is the cost, reports ROI NJ. This is evidence from the most recent Consumers for Quality Care annual survey, which included 603 registered voters in New Jersey. The survey found that New Jerseyans want their elected officials to take action to lower out-of-pocket healthcare costs – eighty-one percent said they are more likely to support a candidate who makes reducing healthcare costs their top priority. The survey also demonstrates widespread support for capping insurance deductibles at a level low enough that people don’t go into debt for needed healthcare and requiring health insurers and pharmacy benefit managers to pass the rebates and discounts they receive from drug companies onto patients.

New York

Survey Highlights Relationship of Food Insecurity and Healthcare
By David Raths | Healthcare Innovation | Aug. 17, 2022

A survey conducted by the New York Health Foundation spotlights the many ways that food insecurity and poor healthcare are interconnected, reports Healthcare Innovation. The results of a 1,507-person statewide survey reveal the tradeoffs individuals make to put food on the table. Twenty-one percent of respondents identified as food-insecure reported delaying or skipping medical care, while 13 percent delayed or skipped purchasing prescription medication. For chronically ill food-insecure individuals, these rates were even higher–twenty-three percent of such individuals reported delaying or skipping medical care, and 16 percent delayed or skipped buying prescription medication. The report also notes that a 2019 study estimated that annual state healthcare costs associated with food insecurity topped $3.4 billion.


Ohio Expands Breast Cancer Screening Coverage
By Brooks Sutherland | Cincinnati Enquirer | June 30, 2022

Ohio passed legislation that requires insurance companies to cover additional screenings for individuals who are at high risk for breast cancer, reports the Cincinnati Enquirer. Dense breast tissue increases the likelihood of cancer and yet just over 40 percent of women aged 40 and over have dense breast tissue show up on mammograms, making it harder to detect cancer. Additional cancer screenings are needed to screen and diagnose breast cancer. Advocates hope that eliminating the cost barrier will also help improve disparities in breast cancer deaths, with women of color experiencing a 41 percent higher mortality than white women.


Healthcare in Oregon Becoming Increasingly Expensive
By Lynne Terry | The Lund Report | July 20, 2022

A new report finds that Oregonians are increasingly paying a bigger share of their income for healthcare, according to The Lund Report. Healthcare costs increased nearly 50 percent between 2013 and 2019; costs increased 4.4 percent in 2019, more than the national average of 3.8 percent. Those with Medicare coverage saw the greatest increase in costs, followed by those with commercial coverage. Hospital costs continue to account for the highest share of spending, followed by provider and other services. 


Many Vermonters Just Got Better Behavioral Healthcare Coverage
By Lexi Krupp l Vermont Public Radio l July 1, 2022

A new Medicaid waiver program in Vermont will expand access to mental health services for residents regardless of income, reports Vermont Public Radio. The waiver will enable the state to eliminate income caps for behavioral health services including community-based interventions and inpatient treatment services for individuals with a substance use disorder (SUD) or serious mental illness. The extension includes provisions allowing for the creation of a new SUD Community Intervention and Treatment eligibility group that will provide benefits such as counseling and residential treatment for low- and moderate-income residents. The goal of the program is to increase access to behavioral health services for people with incomes more than the previous income threshold who do not currently qualify for traditional Medicaid services and for those whose commercial plans don’t cover needed behavioral health treatment. The waiver program will extend for five years.

West Virginia

Food Stamp Work Requirements Increase Mental Healthcare Use
By Kristin Samuelson | Northwestern Now | July 28, 2022

Being exposed to work requirements in order to receive nutrition benefits through the Supplemental Nutrition Assistance Program (SNAP) significantly increased the use of mental healthcare resources, reports Northwestern Now. In 2016, West Virginia introduced work requirements in a pilot program for nine counties–a first-of-its-kind study analyzed its impact using the state’s Medicaid claims data and found that being exposed to work requirements for SNAP worsened depression and anxiety among those who lived in the nine pilot counties. For women, work requirements increased visits for depression and anxiety by 26 and 12 percent, respectively. Men also experienced increased visits, but at a slower rate. Researchers posit that this is because women typically play a larger role in managing family feeding, making them more immediately vulnerable to food insecurity. Though more study is needed, it is possible that these policies not only harm participants’ mental health, but could create additional costs to the Medicaid program in an attempt to save money in the SNAP program.  


Health Expenditures by State of Residence, 1991-2020
By the Centers for Medicare and Medicaid Services | Aug. 12, 2022

The Centers for Medicare and Medicaid Services (CMS) National Health Expenditure Accounts (NHEA) team updated their data on estimates of healthcare spending by state. These data now include the years 2015 to 2020, updating the series that previously ended in 2014. These refreshed data provide information on the amount of health spending by category of expenditure (hospital, physician, prescription drug, etc.) and payer (Medicare, Medicaid and Private Insurance), while including information on total costs and spending per-capita. The new data found drastically varying healthcare costs from state to state: In 2020, per capita personal healthcare spending ranged from $7,522 in Utah to $14,007 in New York. Per capita spending in New York was 37 percent higher than the national average ($10,191) while spending in Utah was about 26 percent lower.