News

COVID-19 Cases Expected to be on the Rise with the Discovery of a New Class of Subvariants

• Scientists have identified a new class of COVID subvariants, dubbed FLiRT. These new subvariants are said to be more infectious than the JN.1 subvariant that was active last year. Scientists do not know the impact this new class will have but believe it will follow similar patterns to JN.1 and, due to increased transmission, could result in increased hospitalization and COVID-19 related deaths. As with COVID-19 cases generally, older adults and those with underlying health issues are at a higher risk of severe illness (Newsweek, May 18).

Medicaid Unwinding Continues to Affect Native American Populations

• As the Medicaid unwinding process continues, many Native American tribal leaders are speaking out and reporting challenges related to redeterminations. Leaders report a lack of timely information, individuals being unaware of the process, long processing times, lack of staffing at the tribal level, lack of communication at the state level, and concerns with obtaining accurate tribal data. While Native American and Alaska Native adults are enrolled in Medicaid at higher rates than their white counterparts, policy experts have been concerned that Indigenous communities would face greater obstacles to renewing healthcare coverage and therefore be disproportionally harmed in the process. Tribal health leaders are concerned that a high number of disenrollments among their members will financially undercut their health systems and that diminishing Medicaid funding will exacerbate long-standing health disparities that plague Native Americans (Missoula Current, May 20).

Bipartisan White Paper Proposes Telehealth Expansion and Medicare Physician Pay Reforms

• On May 17, Senate Finance Committee Chair, Ron Wyden (D-OR), and ranking member, Mike Crapo (R-ID), released a white paper seeking input on reforms to the Medicaid physician payment system and permanent telehealth expansion. The white paper includes the following recommendations: connecting the conversion factor (CF) to the Medicare Economic Index (MEI); increasing incentives for Alternative Payment Models (APMs) such as Accountable Care Organizations (ACOs); considering hybrid payment models to streamline billing processes; and, raising the $20 million threshold for budget-neutrality adjustments without causing payment cuts. Additionally, the white paper discusses the expansion of telehealth flexibilities first started during the COVID-19 pandemic and currently scheduled to expire at the end of 2024, to maintain accessible care for Medicare beneficiaries (Inside Health Policy, May 20).

Federal Legislation

Two House Committee Bills Emerge Calling for Telehealth Extensions

• Two House Committees, the Energy & Commerce and Health Subcommittee (E&C Health Subcommittee) and Ways & Means (W&M), are advancing bills adding a two-year extension of COVID-19 telehealth waivers that would otherwise expire at the end of this year. The bill passed out of the E&C Health Subcommittee, HR 7858, calls for a delay in in-person care and originating site restrictions for mental health services and the extension of audio-only telehealth services for the next two years. The E&C Health Subcommittee bill also includes a payment parity provision to allow telehealth services to be billed the same amount for in-person services at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), while the bill passed out of the Ways & Means Committee, HR 8261, does not. Both bills include preventive measures to fight against Durable Medical Equipment fraud and a five-year waiver extension for the Acute Hospital Care at Home program. These bills also include transparency requirements for pharmacy benefit managers and to delay new changes to Medicare payment rates for clinical lab tests by a year (Inside Health Policy, May 16).

Senate Committee Unveils Comprehensive Dental Reform Act

• On May 17, the Senate HELP committee considered a package of dental reforms, the Comprehensive Dental Care Reform Act of 2024, which aims to address the five drivers of the oral healthcare crisis. The bill aims to address this crisis through increased access to coverage across federal health programs, creating more places to obtain dental care, investing in the oral health profession, educating non-dental health professionals on the significance of oral health, and funding research on prevention and disease management. The bill includes coverage for Medicare, Medicaid, and Veterans Affairs beneficiaries and makes dental services an essential benefit under the Affordable Care Act (ACA). The bill also increases funding for school-based dental services and health clinics and promotes the use of telehealth-enabled dental services (Inside Health Policy, May 17).

New IVF Protection Bill Could Mean Medicaid Funding Cuts for States that Don’t Comply

• Senator Katie Britt (R-AL) and Senator Ted Cruz (R-TX) are co-sponsoring a bill that would require states to protect access to in vitro fertilization (IVF) as a condition for receiving federal Medicaid funding. The bill was advanced following a recent Alabama Supreme Court decision that ruled embryos are considered children, thereby impacting IVF access; after which, Alabama’s Governor signed a bill into law protecting IVF clinics from lawsuits (Alabama Local News, May 20).

Federal Studies and Reports

KFF Data Shows that Non-Expansion States Have Seen Steepest Increase in Enrollment

• According to a KFF analysis, southern, non-expansion states are experiencing some of the most significant growth on state and federal health insurance exchanges. Between 2020 and 2024, all ten southern states experienced significant enrollment growth. Texas experienced growth of 212.2% and Mississippi experienced growth of 189.6%, with Georgia, Tennessee, and South Carolina seeing growth in excess of 100%. Additionally, individuals selecting plans on the exchanges rose from 11.4 million in 2020 to 21.5 million in 2024, an increase of approximately 88%. States using the healthcare.gov federal exchange saw an average enrollment increase of 126% while state-based exchanges saw an average growth of only 22%, partially due to having higher enrollments initially (Health Payer Specialist, May 17).

KFF Analysis Takes Closer Look at Implications of the Nursing Facility Final Rule

• On May 21, KFF published an analysis on the CMS nursing facility final rule that was released in April. The final rule creates new requirements for nurse staffing levels in nursing facilities, as the issue of adequate staffing in nursing facilities has been a long-standing concern. The analysis conducted by KFF used Nursing Home Compare data from April 2024 to compare to the final rule provisions and examine the percentage of nursing facilities that currently meet the final rule minimum staffing requirements. What they found is that in 45 states, fewer than half of nursing facilities have enough staff to meet the new federal requirements. Some other key takeaways include:
  • Less than one in five (19%) of nursing facilities currently meet all three staffing minimums required in the final rule.
  • A smaller share of for-profit facilities currently meets all requirements in the final rule than non-profit and government facilities (11%, 41% and 39%, respectively).
  • Rural nursing homes are as likely as urban facilities to meet the final rule’s requirements based on current staffing levels, but rural facilities will have a longer time period to comply with the new requirements.
  • In over half of states, fewer than one-quarter of facilities meet all three staffing minimums required in the final rule (KFF, May 21).