August 14 Federal Update: Biden Administration Tries to Stem Massive Health Care Coverage Losses

The Biden administration has begun publicly pressuring states to reevaluate internal processes that are leading to massive decreases in health care coverage across the country. In April, states started to make determinations about whether beneficiaries enrolled in Medicaid during the pandemic could stay in the program – a process known as Medicaid unwinding. According to the Kaiser Family Foundation, almost 4.3 million people have lost Medicaid coverage since April, and 74% of disenrollments occurred for procedural reasons, like failure to fill out paperwork in a specific timeframe, rather than ineligibility based on income. There are widespread concerns that many beneficiaries abandon attempts to re-enroll due to long wait times at call centers, language barriers, and arduous bureaucratic processes that states force them to go through. Last week the Centers for Medicare and Medicaid Services (CMS) sent letters to states asking them to address procedural challenges that are stopping eligible people from continuing coverage. The letters recommended states make call center enhancements, use non-English language materials, and opt for automatic over manual renewals. CMS also urged states to implement ex parte renewals, which draw data from sources like the Internal Revenue Service, Social Security, and the Supplemental Nutrition Assistance Program, to confirm income eligibility, rather than waiting for paperwork from beneficiaries.

FDA Approves Pill to Treat Postpartum Depression

On August 4, the Food and Drug Administration approved the first pill meant specifically to treat postpartum depression. The pill, Zurzuvae, is taken once daily for 14 days to treat severe depression following pregnancy, a condition that affects about 1 in 7 new mothers. The pill could be commercially available as soon as October and appears to provide more immediate relief than antidepressants. While the cost is not yet known, experts call it a “hopeful step forward” in making treatment more accessible. Currently, the only other FDA-approved treatment on the market is a $34,000 IV treatment.

Treating postpartum depression can prevent child fatalities and advance child safety and development. Social Current’s efforts to improve child welfare, such as the establishment of the Within Our Reach office, reflect the importance of parental mental health treatment in promoting child safety. This includes recommendations for postpartum depression screening to be conducted at pediatric appointments, a practice that could now lead to mothers being diagnosed and offered a more accessible treatment if Zurzuvae proves to be successful.

President Biden Touts Value of CCBHCs

In recent weeks, President Biden has been boosting mental health care. After proposing new rules that would reinforce the Mental Health Parity and Addiction Equity Act and ensure equal access to both mental and medical benefits, the president addressed the role that Certified Community Behavioral Health Clinics (CCBHCs) play in eliminating barriers to mental health care. In remarks from the White House, Biden said, “These clinics provide a range of services, including crisis support available 24 hours a day and seven days a week, and they serve anyone who needs care, regardless of ability to pay.” In the six years since the first CCBHC opened, over 500 others have sprouted up across the country, offering access to mental health care for low-income communities. CCBHCS work in tandem with the new Crisis and Suicide Lifeline, immediately connecting people in crisis to care. In addition to the impact of health and well-being, CCBHCs led to the creation of 11,000 new behavioral health jobs across the country.

DOE Audit Finds Room for Improvement in Charter School Grant Oversight

An audit released on Aug. 3, entitled “The U.S. Department of Education’s Processes for Overseeing Charter Schools Program Grants to Charter Management Organizations for the Replication and Expansion of High-Quality Charter Schools,” aimed to assess whether the U.S. Department of Education supervised grants in such a way as to ensure accurate annual performance reports and program spending in line with grant requirements. The Department and the Charter School Programs (CSP) office had designed processes to ensure accurate grantee reporting and proper fund utilization. Generally, these processes were followed, but there were shortcomings. For example, the CSP office failed at times to comprehensively fill out Academic Performance Review (APR) forms or communicate concerns with grantees, leading to less than reliable data. The CSP office also lacked proper record-keeping, resulting in the inability to locate a significant number of APRs.

The audit recommends that the Assistant Secretary for Elementary and Secondary Education take several actions:

1. Monitor CSP program officers to ensure accurate completion of APR review templates and effective communication with grantees about issues.
2. Implement procedures to complete corrective action plans, detailing recommended actions and their implementation by grantees.
3. Establish a system for retaining records that demonstrate grantee compliance with corrective actions for fund usage issues.

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