New HPIO fact sheet explores Medicaid enrollment, spending trends during pandemic

The Health Policy Institute of Ohio has released a new fact sheet, “Ohio Medicaid Basics Update: Trends in Enrollment and Expenditures During the COVID-19 Pandemic.”
Since the COVID-19 pandemic began in March 2020, enrollment in, spending on and federal funding for Ohio Medicaid have increased significantly. Drawing from the foundational information provided in HPIO’s Ohio Medicaid Basics 2021 policy brief, this fact sheet provides information on:

  • Changes to the Medicaid program due to the COVID-19 pandemic
  • Enrollment changes during the COVID-19 pandemic
  • Ohio Medicaid spending during the COVID-19 pandemic

“Ohio policymakers must be agile in their response to new challenges facing Medicaid enrollees as the COVID-19 pandemic continues, including the end of the (public health emergency) and potential loss of Medicaid eligibility for tens of thousands of Ohioans,” the fact sheet concludes. “State policymakers and other stakeholders must also balance the benefits of the Medicaid program with budgetary and administrative challenges to improve health, achieve equity and promote sustainable healthcare spending in Ohio.”

Feds extend COVID public health emergency another three months

The United States on Wednesday renewed the COVID-19 public health emergency, allowing millions of Americans to keep getting free tests, vaccines and treatments for at least three more months (Source: “U.S. renews COVID-19 public health emergency,” Reuters, April 13).

The public health emergency was initially declared in January 2020, when the coronavirus pandemic began. It has been renewed each quarter since and was due to expire on April 16.

The Department of Health and Human Services (HHS) in a statement said it was extending the public health emergency and that it will give states 60 days notice prior to termination or expiration.

As National Minority Health Month begins, racial disparities in COVID vaccinations narrow, but persist


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The federal Department of Health and Human Services Office of Minority Health kicks off National Minority Health Month today with a focus on addressing disparities in vaccination rates.

Although the difference in vaccination rates for Black and white Ohioans persists, the gap has decreased in recent months. According to a national study conducted by Harvard researchers, “lack of access to the COVID-19 vaccine among minority populations in the U.S., rather than lower willingness to receive the vaccine, may have played a greater role in the racial-ethnic disparities we experienced in the early phases of the U.S. vaccination campaign.”

As of March 31, 57% of white Ohioans and 45% of Black Ohioans had completed vaccines for COVID-19 (two doses of either Pfizer or Moderna or one dose of Johnson & Johnson). That gap in vaccination rates has narrowed from a 29% difference between the two groups in November 
to a 23% difference as of this week (see graphic above).

As part of its annual recognition of Minority Health Month, the Ohio Commission on Minority Health has released an extensive calendar of events. Throughout the month, HPIO plans to release new data graphics exploring health disparities in the state. More information and resources about health equity in Ohio is available on HPIO’s website.

Ohio University study links COVID death rates to residential segregation

A new study has found that COVID-19 death rates among both Black and white people were higher in areas with more residential segregation, with rates for Black individuals almost twice as high (Source: “Study links racism, segregation to increased COVID deaths,” Atlanta Journal-Constitution, March 14).
The study from an Ohio University researcher, published in the journal Ethnicity & Disease, looked at systemic racism measures, as well as socioeconomic factors between Black and white residents, in every state. Using data on deaths through December 2020, they assessed whether state-level systemic racism and residential segregation predicted the probability of COVID-19 deaths among Americans, considering sociodemographic factors in the process.
“We were interested in doing this study because racial and ethnic disparities have been apparent amid COVID-19, and for some Americans, this may have been one of the first times they’ve learned about disparities,” said study author Berkeley Franz. “Health disparities are present with almost every illness and have persisted for years, and the gap isn’t closing, especially between Black and white Americans. We wanted to understand what was driving those disparities to find better ways to reduce them.”
What they found was the death rate was higher among Black individuals because of social environments rather than physiology or genetics. They hypothesized that in segregated neighborhoods, residents are less likely to have access to good quality schools, employment opportunities, health care and other resources.

CDC: More than 90% of Americans live in areas where masks not needed

The U.S. Centers for Disease Control and Prevention (CDC) on Thursday said 93% of the U.S. population live in locations where COVID-19 levels are low enough that people do not need to wear masks indoors (Source: “More than 90% of U.S. population in areas where masks not needed -CDC,” Reuters, March 3).

Last week, the CDC dramatically eased its COVID-19 guidelines for when Americans should wear masks indoors, saying they could drop them in counties experiencing what it described as low or medium COVID-19 levels.

The latest figures are an increase from just a week ago, a further indication that COVID hospitalizations - a key benchmark for the new masking recommendations - continue to fall. The agency said on Thursday that 85.4% of counties now rank as low or medium risk and 92.9% of the population lives in those counties.

Study finds anxiety, depression spiked 25% in first year of pandemic

Rates of anxiety and depression rose by about 25% worldwide in the first year of Covid-19, another indication of the widespread harm on mental health inflicted by the pandemic (Source: “Hidden Harm: World Saw Spike in Anxiety, Depression in Covid’s First Year,” Bloomberg, March 2). 

Young people were at the greatest increased risk of suicide and self-harm, and women bore the brunt of the emotional and psychological burden, according to a report from the World Health Organization. People with chronic conditions such as asthma or cancer were also more likely to develop symptoms of mental disorders during the outbreak. 

Evidence of the ongoing toll of isolation, restrictions and financial worries are continuing to mount. The WHO report mirrors a study in The Lancet medical journal last year that found the pandemic had resulted in an extra 53.2 million cases of major depressive disorder and an extra 76.2 million cases of anxiety disorders globally.  

“The information we have now about the impact of Covid-19 on the world’s mental health is just the tip of the iceberg,” said WHO chief, Tedros Adhanom Ghebreyesus. He called on countries to pay more attention to mental health and provide support. An increasing number of people are using online help, but that’s a challenge in areas with limited resources. 

Ohio COVID rate lowest since August

This week, Ohio again saw a significant drop in COVID-19 cases per 100,000 residents with numbers at their lowest level since mid-August (Source: “COVID-19 rates hit lowest point since August,” (Warren) Tribune Chronicle, Feb. 18).

It was the fourth consecutive week of declines after 11 straight weeks of increases. The state saw a 46.8% reduction in cases per 100,000 residents from last week and a 371% decline from two weeks ago. 

There were 255.8 COVID-19 cases per 100,000 residents for the period between Feb. 3 and Wednesday compared to 481 cases per 100,000 last week, according to Ohio Department of Health data. The CDC defines high transmission as 100 or more cases per 100,000. Ohio's rate hasn’t been below that threshold since July 29 when 77.4 COVID-19 cases per 100,000 residents were reported by the ODH.

States brace for Medicaid redetermination following end of health emergency

The Biden administration and state officials are bracing for a great unwinding: Millions of people losing their Medicaid benefits when the pandemic health emergency ends (Source: “Why Millions on Medicaid Are at Risk of Losing Coverage in the Months Ahead,” Kaiser Health News, Feb. 14).

Before the public health crisis, states regularly reviewed whether people still qualified for the safety-net program, based on their income or perhaps their age or disability status. While those routines have been suspended for the past two years, enrollment climbed to record highs. As of July, 76.7 million people, or nearly 1 in 4 Americans, were enrolled, according to the Centers for Medicare and Medicaid Services.

When the public health emergency ends, state Medicaid officials face a huge job of reevaluating each person’s eligibility and connecting with people whose jobs, income and housing might have been upended in the pandemic. People could lose their coverage if they earn too much or don’t provide the information their state needs to verify their income or residency.

The Biden administration is giving states a year to go through the process, but officials say financial pressures will push them to go faster. Congress gave states billions of dollars to support the coverage requirement. But the money will dry up soon after the end of the public emergency — and much faster than officials can review the eligibility of millions of people, state Medicaid officials say.

COVID cases declining in Ohio, but still 'quite high,' ODH director says

COVID-19 hospitalizations and cases are continuing to decrease in Ohio after the record-setting omicron variant peaked in January (Source: “Ohio’s COVID hospitalizations, cases continue to decline but remain high,” Dayton Daily News, Feb. 10).

In the past three weeks, Ohio’s seen the number of COVID patients in the state’s hospitals and ICUs decrease by 50%.

“While I think we can all be very encouraged by the improving trends we’re seeing all across the state, let’s remember that our numbers in Ohio are really still quite high and we need to be careful not to let our guard down too soon,” said ODH Director Dr. Bruce Vanderhoff.

Despite the decrease in coronavirus cases, Ohio’s transmission rate is still nearly five times higher than the Centers for Disease Control and Prevention’s definition of a high transmission rate. In the past two weeks, Ohio is averaging 481 COVID-19 cases per 100,000 people. The CDC defines a high transmission rate as 100 cases or more per 100,000 people. None of the state’s 88 counties reported fewer than 100 COVID cases per 100,000 people.

OSU study finds COVID vaccine hesitancy falling faster among Black Americans

While the COVID vaccination rate for Black Americans still lags white Americans, a new study found that hesitancy among Black individuals is falling at a faster rate (Source: “COVID Vaccine Hesitancy Falling Faster Among Black Americans Than Whites,” HealthDay News via U.S. News, Jan. 24).

According to the study by Ohio State University researchers published in JAMA Network Open, In December 2020, about 38% of Black participants and 28% of white participants expressed hesitancy about the vaccines. By June 2021, those responses had shifted so they were almost even, with 26% of Black participants hesitant compared to 27% of white participants.

Still, by May 2021, the percentage of white individuals who had received at least one dose of vaccine was about 1.5 times the percentage of Black individuals who had received a dose.

If, as the study showed, it's not that Black Americans are more hesitant than white individuals, but they remain less vaccinated, "then we really need to ask ourselves, is it access barriers that are affecting Black Americans more?" said Tasleem Padamsee, lead study author.

Though this study was not focused on the reasons for the lower vaccination rates, it pointed out that various obstacles might keep Black people from getting vaccinated. Potential obstacles could include concern about missing work to get the vaccine or missing it afterward due to side effects, not having transportation to the vaccine site or worrying that there may be a cost for vaccines.