HHS Approves Groundbreaking Medicaid Initiatives in
Massachusetts and Oregon
Initiatives
will ensure children in Oregon have continuous Medicaid coverage until
the age of six, and expand access to coverage and address
nutrition and
housing needs in Massachusetts and Oregon
Approvals of
the initiatives come during the White House Conference on Hunger,
Nutrition, and Health, taking direct action on the Biden-Harris
Administration’s National Strategy to end hunger, reduce diet-related
diseases, and eliminate health inequities
Today,
the U.S. Department of Health and Human Services (HHS), through the
Centers for Medicare & Medicaid Services (CMS), approved
groundbreaking Medicaid section 1115 demonstration initiatives in
Massachusetts and Oregon. Both demonstrations aim to test improvements
in coverage, access, and quality with innovative approaches to ensure
more eligible people retain their Medicaid coverage, including by
approving Oregon’s demonstration to keep children enrolled in Medicaid
up to age six — preventing gaps in coverage that can cause children to
lose access to needed care in their formative early years.
The
initiatives also take steps to address unmet health-related social
needs, such as by giving Massachusetts and Oregon new authority to test
coverage for evidenced-based nutritional assistance and medically
tailored meals, clinically-tailored housing supports, and other
interventions for certain beneficiaries where there is a clinical need.
These efforts coincide with the White House Conference on Hunger, Nutrition, and
Health, where the Biden-Harris Administration released its
national strategy to end hunger, improve nutrition and physical
activity, and reduce diet-related diseases and disparities – all goals
supported by the initiatives approved today.
“This
is an historic moment in our nation’s fight to end hunger and improve
health equity, particularly in states like Oregon and Massachusetts,”
said HHS Secretary Xavier Becerra. “Groundbreaking action in each state
will ensure children and youth remain connected to health care, and
that we double down on tackling social needs impacting health, such as
nutrition. Everyone should get the access to care they need to live
safe and healthy lives.”
“I’m
proud to partner with Oregon and Massachusetts to improve quality and
access, reduce health disparities, and improve health equity, for those
who need it most. For the first time ever, children with Medicaid
coverage in Oregon will be able to keep their coverage until the age of
6 — ensuring they can get the care they need during their formative
years. This is just one aspect of the groundbreaking demonstration
initiatives that I’m approving today,” said CMS Administrator Chiquita
Brooks-LaSure. “These states are also partnering with community-based
providers to address the root social causes of health concerns, like
lack of access to nutritious food and housing insecurity. We applaud
Massachusetts and Oregon for helping us use every tool available to
protect and expand access to high-quality, comprehensive, affordable
health care coverage.”
Under
the Biden-Harris Administration, thanks to the American Rescue Plan and
other Administration efforts, more Americans than ever before have
health insurance coverage. Today’s approvals will build on these
efforts and support President Biden’s executive orders in April 2022
and January 2021 directing federal agencies to take action to expand
affordable, quality health coverage, including by strengthening
Medicaid and the Affordable Care Act.
Both
demonstrations approved today will work to improve enrollment and
continuity of coverage. In Oregon, children determined eligible for
Medicaid will be able to stay continuously enrolled until they turn six
years old, without their families needing to renew their coverage. This
will minimize red tape for both families and the state, and help to
ensure access to care throughout this critical period of early
childhood. Individuals older than six will be able to keep their
coverage for up to two years, even if their household income
fluctuates. Massachusetts will provide up to 12 months of continuous
coverage for Medicaid and Children's Health Insurance Program (CHIP)
beneficiaries upon release from correctional settings and 24-months of
continuous eligibility for beneficiaries with a confirmed status of
chronic homelessness, eliminating gaps in coverage for these vulnerable
populations.
Evidence
indicates that health-related social needs, such as food insecurity and
housing instability, are critical drivers of an individual’s health
outcomes. With this demonstration, Massachusetts will receive expanded
authority to provide certain time-limited housing supports, clinical
nutrition education, and medically-tailored food assistance services
when medically appropriate. These services will be available to a range
of at-risk populations, including postpartum individuals for up to 12
months. Massachusetts will also provide additional meal support for certain
households when an eligible beneficiary is a child or pregnant woman
with special clinical needs. Oregon will expand health-related
social needs coverage for certain food assistance, housing supports,
and other interventions that are medically appropriate for individuals
experiencing certain life transitions, including individuals who are
homeless or at risk of homelessness. In both states, the time-limited
housing and nutritional support services provided in the demonstration
can be expected to stabilize the housing and nutritional circumstances
of these Medicaid enrollees and thus ensure that they will keep
receiving and benefiting from the Medicaid-covered services to which
they are entitled.
Massachusetts
will also be implementing an innovative Hospital Quality and Equity
Initiative for private acute hospitals and the Commonwealth’s only
non-state-owned public hospital, Cambridge Health Alliance. The
initiative is expected to reduce health inequities by improving
outcomes in populations that are likely to face barriers to quality
health care. As such, the demonstration is likely to help improve the
quality of care and is also likely to reduce health disparities through
this value-based care approach.
CMS
will require both states to systematically monitor the demonstrations
and conduct rigorous independent evaluations to determine the outcomes
and impacts.
For
additional information about the Massachusetts’ MassHealth Section 1115
Demonstration, please visit: https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82006.
For
additional information about the Oregon Health Plan Section 1115
Demonstration, please visit: https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82956.
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