State Data and Policy Actions to Address Coronavirus

In late 2019, a new strain of coronavirus emerged in China. With the number of cases of COVID-19, the disease caused by this coronavirus, growing rapidly in the United States and around the world, the World Health Organization declared it a pandemic on March 11, 2020. Controlling the spread of the virus requires aggressive action from states and the federal government to ensure access to testing for those who need it and treatment for those who contract the disease.

To date, states have taken a number of actions to mitigate the spread of the virus and reduce barriers to testing and treatment for those affected. This data tool provides state-level information on:

These data will be updated regularly, and new information will be added in response to the evolving situation.

[Visit our Medicaid Emergency Authority Tracker for information on approved state Medicaid emergency authorities to address the coronavirus crisis, and our special coronavirus topic page for all our resources.]

 

State Social Distancing Actions

 

On March 13, 2020, President Trump declared a state of emergency over the coronavirus in an effort to enhance the federal government’s response to the pandemic. At that time, a number of states had already declared some type of emergency, and by March 16, 2020, every state had made an emergency declaration, with most taking the form of a State of Emergency or a Public Health Emergency. Such emergency declarations allow governors to exercise emergency powers that may include activating state emergency personnel and funds, supporting the needs of local governments, protecting consumers against price gouging, and adjusting regulations to maximize access to health care. States, especially those hardest hit by the outbreak, took additional actions to slow the spread of the virus. These social distancing measures included mandatory stay at home orders, closures of non-essential businesses, bans on large gatherings, school closures, and limits on bars and restaurants and other public places. With regard to the actions included in this resource, with the exception of school closures, the map and table include only mandates ordered by a state’s executive branch (not state legislature). The authority of governors to issue such mandates may vary by state.

After having social distancing requirements in place for several weeks, states have begun to roll back some of these measures by allowing some or all non-essential businesses to reopen, rescinding stay at home orders, easing restrictions on in-person dining at restaurants, and/or easing large gathering bans. These actions to roll back social distancing requirements will appear in the map and table when they take effect, which may occur several days after they are announced.

 

State Social Distancing Actions

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State COVID-19 Health Policy Actions

 

With enactment of the Families First Coronavirus Response Act on March 18, 2020, the federal government took action to ensure access to COVID-19 testing. The legislation requires Medicare, Medicaid, all group health plans, and individual health insurance policies to cover testing and associated visits related to the diagnosis of COVID-19 with no cost sharing and prohibits plans from imposing prior authorization requirements on these services during the federally-declared emergency period. In addition, the new law gives states the option to provide Medicaid coverage of COVID-19 testing for uninsured residents with 100% federal financing.

Many states have also implemented policies to increase access to COVID-19 testing and treatment, as well as continued management of other health conditions. Some states have already indicated that they are requiring insurers to cover a COVID-19 vaccination with no cost-sharing if and when one becomes available, while others are requiring state-certified insurance carriers to waive patient cost-sharing for COVID-19 treatment, as well as treatment for other related conditions, including pneumonia and the flu. States have also announced other actions, including extending special enrollment periods in state-based health insurance marketplaces, facilitating early prescription drug refills, and relaxing prior authorization and utilization review processes. A number of states have responded to the pandemic by expanding access to telehealth services as well, with detailed actions captured in the telehealth-specific table below. In addition, states are requesting approval for Section 1135 waivers that permit them to waive or modify certain Medicare, Medicaid, CHIP, and HIPAA requirements during a national emergency.

Finally, while the new federal law creates a federal emergency paid sick leave program through December 2020, a number of states have enacted mandatory sick leave policies that will fill in gaps in the new federal emergency leave, while others are proposing to adopt these policies in the wake of the coronavirus outbreak.

With regard to the actions included in this resource, the map and table include only mandates (not recommendations or guidance) ordered by a state’s executive branch (not state legislature). The authority of governors to issue such mandates may vary by state. The actions pertain only to state-regulated private plans and do not include self-insured employer plans or public plans such as Medicare and Medicaid.

 

State COVID-19 Health Policy Actions

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State Actions on Telehealth

 

Additional State-level Data

State Reports of Long-Term Care Facility Cases and Deaths Related to COVID-19 (as of July 30, 2020)

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Guidance for Assisted Living Facilities Related to COVID-19 (as of June 1, 2020)

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Adults at Higher Risk of Serious Illness if Infected with Coronavirus

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Health Care Provider Capacity

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Critical Care Workforce

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Medicaid Expansion Status and Health Insurance Coverage

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Private Insurance Deductibles and Self-Insured Plans

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Influenza and Pneumonia Deaths and Vaccinations

This tool was developed by Jennifer Tolbert, Cornelia Hall, Kendal Orgera, Natalie Singer, Salem Mengistu, Marina Tian, and Amrutha Ramaswamy.

Notes and Sources