In April, the federal government released $485 million in grants to states to combat the opioid crisis. The amounts of the grants, the same in both 2017 and this year, vary from $2million to states with less population to $44.7 million dollars to California.
Ten emergency departments in Colorado volunteered to participate in a Colorado Hospital Association project to reduce the use of opioids over a six-month period in 2017. Data collected upon completion of the project showed a 36 percent reduction in opioid use, far exceeding the project goal of a 15 percent reduction. All ten hospital emergency departments posted opioid prescription rates beat the 15 percent reduction goal.
While state policy makers frequently express concern about the increasing percentage of state funds required to fund their Medicaid programs, the programs bring in large amounts of federal dollars to states. Across all states, two thirds of all federal grant funds received by states in 2017 are for Medicaid health services for low-income, disabled and elderly individuals.
Jason Helgerson, leaving his job this week as New York Medicaid director after 7 years, blogged in Health Affairs about the lessons he learned. He says in the post that when his New York experience is combined with the previous 4 years as Wisconsin Medicaid director, he is the nation’s longest-serving Medicaid director. The average tenure of a Medicaid director, according to Helgerson, is 19 months.
Earlier this week, the head of the U.S. Centers for Medicare and Medicaid, Seema Verma, travelled to Arkansas and signed a waiver request to require Medicaid enrollees to work or prepare for a job. The work requirement will only impact the expansion population, specifically childless adults 19 to 49 years old. They will be required to work or participate in activities such as volunteering or vocational training for 20 hours per week. The requirement will be phased in between June and September 2018.
Both chambers in Wisconsin have passed a $200 million reinsurance plan that would provide funds to insurers for high-cost patients’ expenses to prevent ACA marketplace premium increases in 2019. The Governor has come out in support of the program and is expected to sign the bill, according to the Journal Sentinel.
Open enrollment for health insurance policies sold under the Affordable Care Act marketplaces ran for 6 weeks the end of 2017. Enrollment was down from 2017 – by 3.7 percent – but nonetheless 11,760,533 Americans selected a health insurance plan for 2018.
Read about top health issues facing states in 2018. Medicaid expenditures are 30 percent of states general fund budgets and states are looking for ways to cut costs. The opioid epidemic shows no signs of letting up, increasing the need for treatment, harm reduction programs and prevention. Questions of how to provide health service to the growing aging population and rural populations are top-of-mind in many states. Finally, state policymakers are beginning to look at the social determinants of health, searching for strategies that are more preventive in nature.
The Children’s Health Insurance Program – also known as CHIP – has figured prominently in the deliberations on keeping the federal government open. Reporting today by Governing magazine says that the details of the vote later today have not been made public, so the fate of the six-year funding appropriation for CHIP that was included in the House continuing resolution is unclear.