HIMSS Chapter Advocates and state/local-focused partners enter a new advocacy season with many new opportunities to engage new and current state legislators, governors and other state officials about the value of health information and technology.
The 2018 midterm elections saw more than 6,000 state legislative seats in the running along with 36 open governorships. Before this, there were 34 states with trifectas (one party held the governorship and both houses of the state legislature). Twenty-six of 34 trifectas were Republican and eight were Democratic.
Results posted on Ballotpedia indicated the following election outcomes:
Overall, 11 total states saw a trifecta status change in some way.
Healthcare was a significant issue to voters during the 2018 state midterm elections. Largely, state candidates prioritized healthcare focusing on Medicaid expansion from the Affordable Care Act (ACA). Prior to Nov. 7, 17 States had not chosen to expand their Medicaid coverage.
ACA’s Medicaid Expansion requires a state to provide Medicaid coverage for persons under the age of 65, and with incomes equal to or below 138 percent of the federal poverty level – covering 10 percent of the costs associated with the expansion.
The midterm state elections saw a number of states place healthcare directly on their ballot. For instance, voters from Idaho, Nebraska and Utah approved measures to adopt Medicaid expansion.
Here is how expansion efforts rolled out across states:
Medicaid expansion is important to the health information and technology community because it expands access to coverage for millions of Americans that fall below the poverty line. HIMSS Chapter Advocates and state partners will need to keep strong situational awareness of these issues, given the opportunities it brings to expand digital health across the spectrum of care within states.
The Centers for Medicare and Medicaid (CMS) has granted states opportunities through the Medicaid 1115 waiver program, or the 90 percent enhanced federal financial participation (FFP) for Medicaid technology investment (aka 90/10 Match), to modernize state health IT systems and improve prevention, early identification, and treatment of both physical and behavioral health needs.
Expansion states also have access to new more flexible funding opportunities that can empower states and local health providers to improve response to public health crises such as the opioid epidemic and chronic diseases through surveillance and care integration across the spectrum of community providers.
Most recently, CMS has expanded opportunities of the program by allowing certain technology initiatives to be funded at 90 percent for design/development/implementation, and 75 percent for operations/maintenance (note: this is not HITECH funding which runs out in 2021, but our ongoing technology funding for systems). You can find more details in this letter from CMS to state Medicaid directors.
Based on the 2018 midterm elections, HIMSS Chapter Advocates may take action to elevate the role of health information and technology by addressing the following areas:
The HIMSS State Affairs team will continue to monitor new state health IT policies and initiatives through 2019 by tracking:
HIMSS members, chapter advocates and leaders can find more information on state and local efforts by visiting the HIMSS Policy Center.
Read another midterms election debrief from a congressional affairs perspective.
Explore other recent policy updates:
HIMSS Remains Active on Federal Policy Issues
How States, Territories and Private Organizations Can Leverage Health IT Solutions During Natural Disasters
CMS Finalizes 2019 Medicare Physician Fee Schedule and Quality Payment Program Rule
HIMSS Comments on Anti-Kickback Request for Information
HIMSS Responds to NSF Artificial Intelligence Request for Information