States that accept the enhanced federal funding can resume disenrollments beginning in April but must meet certain reporting and other requirements during the unwinding process. However, the Administrations superseding debt forgiveness program is still pending in the courts. Especially after reports showing worsening health outcomes for mothers, investing these funds into extending Medicaid postpartum coverage is critical, said Rep. Robin Kelly (D-Ill.), who leads the health care task force for the Congressional Black Caucus. It also provides states more time to prepare for new rules that will put millions in jeopardy of losing their health insurance, something state Medicaid directors have been demanding from legislators. NOTE: States may not elect a period longer than the Presidential or Secretarial emergency declaration . However, if the guardrails are too flimsy or non-existent, states could see a surge in their uninsured populations right as government Covid funding runs dry, and individuals will have to depend on health plans to cover tests, vaccines and therapeutics for the virus. CMS guidance also outlines specific steps states can take, including ensuring accessibility of forms and notices for people with LEP and people with disabilities and reviewing communications strategies to ensure accessibility of information. This is something both Democratic and Republican states asked for so that the 90 million people enrolled in Medicaid can be given certainty and protected during this massive undertaking.. In January 2020, the federal government enacted a national public health emergency that has since served as the "primary legal pillar of the U.S. pandemic response." 1 The emergency. hbbd```b``>"IOjfo H80 f3Or e: ,`2DI[ v&,HK I+@ R
And since coverage cannot be backdated, its essential to ensure that youre covered before any medical needs arise. 2716, the Consolidated . In some states, it will be the most significant enrollment action in the 50+ year history of Medicaid.
Under the ACA, states must seek to complete administrative (or ex parte) renewals by verifying ongoing eligibility through available data sources, such as state wage databases, before sending a renewal form or requesting documentation from an enrollee. Findings This cohort study of 4869 Latina patients with gestational (n = 2907) or preexisting diabetes (n . People who can't access the website or who . At the start of the pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA), which included a requirement that Medicaid programs keep people continuously enrolled through the end of the month in which the COVID-19 public health emergency (PHE) ends, in exchange for enhanced federal funding. On January 30, 2023, the Biden administration announced its intention to make final extensions of both the COVID-19 National Emergency (NE) and the COVID-19 Public . No one thought the public health emergency would stay forever. Meghana Ammula The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. endstream
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<. This policy update will examine several of the health-related COVID-19 Federal Emergency Declarations and which flexibilities will end in May. However, when states do need to follow up with enrollees to obtain additional information to confirm ongoing eligibility, they can facilitate receipt of that information by allowing enrollees to submit information by mail, in person, over the phone, and online. HHS projects that approximately 15 million people will lose eligibility for Medicaid once the normal eligibility redetermination process resumes. The Congressional Budget Office assumes the public health emergency for Covid will expire in July barring another extension by the Biden administration. forced a handful of successful Senate votes. A KFF analysis revealed that among people disenrolling from Medicaid, roughly two-thirds (65%) had a period of uninsurance in the year following dise0nrollment and only 26% enrolled in another source of coverage for the full year following disenrollment (Figure 12). March 31, 2023 is the last day that states have to maintain the continuous coverage rules that have been in place since March 2020. Get an email every time we post. The PA MEDI Helpline is available at 1-800-783-7067 from 8 a.m. to 5 p.m. Monday-Friday. . Medicaid provides coverage to a vast. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. Enrollees who have moved may not receive important renewal and other notices, especially if they have not updated their contact information with the state Medicaid agency. 3. Medicaid enrollment increased by over 17 million from February 2020 to May 2022. Thats because Medicaid and CHIP eligibility for children extend to significantly higher income ranges, and marketplace subsidies are never available if a person is eligible for Medicaid or CHIP. Key Points. 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision, 10 Things to Know About Medicaid Managed Care, FAQs on Health Spending, the Federal Budget, and Budget Enforcement Tools, Health Insurer Financial Performance in 2021. People using this window can elect to have their Medicare coverage retroactive to the day after their Medicaid ended, although any back premiums would have to be paid in that case. (Note that there are several terms that are used interchangeably: Eligibility redetermination, renewal, case review, recertification, and redetermination all mean the same thing, and refer to the process by which the state determines whether a Medicaid enrollee is eligible to continue to receive Medicaid.). On January 5, 2023, CMS released an Informational Bulletin that included timelines for states to submit a renewal redistribution plan (discussed above), system readiness plans and results, and baseline unwinding data based on when states plan to begin renewals. While the PHE ends on May 11, in payments rules CMS has extended the waivers for an additional 152 days to allow providers time to undo the waivers. Those participating in the negotiations caution that some details remain unresolved and the deal could still fall apart as lawmakers and staff rush to finalize the bill language, but interest from both sides is mounting. Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California. Additionally, nearly six in ten assister programs said they had proactively reached out to their state to explore ways to help consumers; supported the state sharing contact information with them on individuals who need to renew their Medicaid coverage; and were planning to recontact Medicaid clients to update their contact information. The number of states reporting they complete more than 50% of renewals using ex parte processes for non-MAGI groups (people whose eligibility is based on being over age 65 or having a disability) is even lower at 6. Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. Medicaid eligibility redeterminations will resume in 2023. That's at least in part due to 2020's Families First Coronavirus Response Act, which required state Medicaid programs to keep beneficiaries enrolled through the duration of the pandemic. It can be allowed to expire at the end of the 90-day period or terminated early if deemed appropriate. The main waivers are: The end of the PHE will also have an effect on the Medicaid program. Both . President Biden says the emergency order will expire May 11. Update regarding intent to end the national emergency and public health emergency declarations and extensions by way of the Consolidated Appropriations Act (CAA) for Fiscal Year 2023 Update: On Thursday, December 29, 2022, President Biden signed into law H.R. A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994. And if this passes, Congress will essentially give states a 98-day notice.. Twenty-eight states indicated they had settled on plan for prioritizing renewals while 41 said they planning to take 12 months to complete all renewals (the remaining 10 states said they planned to take less than 12 months to complete renewals or they had not yet decided on a timeframe). The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. On January 30, the Biden Administration announced May 11, 2023, as the targeted end date for the national public health emergency (PHE) declarations implemented during the COVID-19 pandemic. 541 0 obj
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Its understandable that a primary goal of the redetermination process is to ensure that these individuals transition to other coverage, either from an employer or through the exchange/marketplace.
Section 319 of the Public Health Service Act gives the federal HHS Secretary the authority to make such a declaration when a severe disease . In 2020, one in ten Medicaid enrollees moved in-state and while shares of Medicaid enrollees moving within a state has trended downward in recent years, those trends could have changed in 2021 and 2022. The proposed eligibility and enrollment rule aims to smooth transitions between Medicaid and CHIP by requiring the programs to accept eligibility determinations from the other program, to develop procedures for electronically transferring account information, and to provide combined notices. States can also consider sharing information on consumers losing Medicaid who may be eligible for Marketplace coverage with Marketplace assister programs; however, in a recent survey, few assister programs (29%) expected states to provide this information although nearly half were unsure of their states plans. 3179 0 obj
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For the first quarter of 2023, states will continue to get the 6.2 percentage point boost that theyve been receiving throughout the pandemic. Similarly, a survey of Marketplace assister programs found that assister programs were planning a variety of outreach efforts, such as public education events and targeted outreach in low-income communities, to raise consumer awareness about the end of the continuous enrollment provision (Figure 9). This will be the case, for example, for someone who was enrolled under Medicaid expansion guidelines (which only apply through age 64) and has turned 65 during the PHE. Medicaid and CHIP Services Information for People Receiving Services English Espaol In response to the COVID-19 pandemic, the federal government declared a public health emergency (PHE) and passed a law that allowed you to automatically keep your Medicaid coverage (continuous Medicaid). Ensuring accessibility of information, forms, and assistance will be key for preventing coverage losses and gaps among these individuals. States can also work with community health centers, navigators and other assister programs, and community-based organizations to provide information to enrollees and assist them with updating contact information before the continuous enrollment period ends, completing the Medicaid renewal process, and transitioning to other coverage if they are no longer eligible. But they could choose to do so, and could also choose to waive premiums for CHIP during that time. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision. . An Informational Bulletin (CIB) posted on January 5, 2023 included timelines for states to submit a renewal redistribution plan. Sharing updates regarding the end of public health emergency declarations and extensions by way of the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. . Any information we provide is limited to those plans we do offer in your area. Congress has extended the telehealth flexibility through the end of 2024, but it is unclear if it will be extended further or made permanent. But our goal today is to help you understand what you need to know in order to maintain coverage if youre one of the millions of people who could potentially lose Medicaid eligibility in the coming months. By law, public health emergencies are declared in 90-day increments. 2022-2023 Medicaid Managed Care Rate Development Guide. Under the previous rules, established by the Families First Coronavirus Response Act, states would have been allowed to start redetermining Medicaid eligibility after the end of the month that the PHE ended. As part of the Consolidated Appropriations Act, 2023, signed into law on December 29, 2022, Congress set an end of March 31, 2023 for the continuous enrollment provision, and phases down the enhanced federal Medicaid matching funds through December 2023. As of January 10, 2023, CMS had approved a total of 158 waivers for 41 states (Figure 6). Together, these findings suggest that individuals face barriers moving from Medicaid to other coverage programs, including S-CHIP. including education, public health, justice, environment, equity, and, . CMS guidance provides a roadmap for states to streamline processes and implement other strategies to reduce the number of people who lose coverage even though they remain eligible. The COVID-19 Public Health Emergency (PHE) that was declared in March 2020 is set to end on May 11, 2023, as the President has announced there will be no more extensions to the PHE. The latest extension will expire on April 16, 2022. Additionally, people with LEP and people with disabilities are more likely to encounter challenges due to language and other barriers accessing information in needed formats. | Jae C. Hong/AP Photo. But even if youre eligible for this ongoing special enrollment period, its still in your best interest to submit an application as soon as possible if you find out that youll be losing your Medicaid coverage. Outside GOP advocates working closely with Congress argued that if those guardrails are built too high, the policy move might not yield the federal revenue thats driving the discussion in the first place. Browse plans and costs with an easy, anonymous online tool. Efforts to conduct outreach, education and provide enrollment assistance can help ensure that those who remain eligible for Medicaid are able to retain coverage and those who are no longer eligible can transition to other sources of coverage. The GOP-led Senate passed the proposal in the 2022 session, but it was killed in the House. Medicaid is a prime example: As of late 2022, enrollment in Medicaid/CHIP stood at nearly 91 million people, with more than 19 million new enrollees since early 2020. These waivers include strategies allowing states to: renew enrollee coverage based on SNAP and/or TANF eligibility; allow for ex parte renewals of individuals with zero income verified within the past 12 months; allow for renewals of individuals whose assets cannot be verified through the asset verification system (AVS); partner with managed care organizations (MCOs), enrollment brokers, or use the National Change of Address (NCOA) database or US postal service (USPS) returned mail to update enrollee contact information; extend automatic enrollment in MCO plans up to 120 days; and extend the timeframe for fair hearing requests. If you no longer meet your states Medicaid eligibility guidelines, its a good idea to understand what your options will be when your state begins disenrolling people who are no longer eligible. Required fields are marked *. But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. A recent analysis of churn rates among children found that while churn rates increased among children of all racial and ethnic groups, the increase was largest for Hispanic children, suggesting they face greater barriers to maintaining coverage. These waivers will be available on a time-limited basis and will enable states to facilitate the renewal process for certain enrollees with the goal minimizing procedural terminations. Heres what enrollees need to know. While nearly all states accept information by mail and in person, slightly fewer provide options for individuals to submit information over the phone (39 states) or through online accounts (41 states). That is now expected to happen in May 2023. This is true regardless of whether youll qualify for the new low-income special enrollment period, since youll have a normal loss-of-coverage special enrollment period when your Medicaid ends, and you can take advantage of it right away. For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. In the third quarter, it will drop to 2.5 percentage points, and in the fourth quarter of 2023, states will receive 1.5 percentage points in additional federal Medicaid funding. (PHE) ends. What does this mean for Medicaid? The public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. Follow @meg_ammula on Twitter Friday, February 24, 2023. We are not ending the PHE, said a Capitol Hill source close to the negotiations, granted anonymity to discuss a deal that is still in flux. If you dont have access to an employer-sponsored plan and you are eligible for marketplace subsidies (most people are), the best course of action is to enroll in a marketplace plan as soon as you know that your Medicaid coverage will be terminated, in order to avoid or minimize a gap in coverage. You can share your story about the impact of the Public Health Emergency HERE. On April 12, 2022, the Secretary of Health and Human Services (HHS), Xavier Becerra, announced the extension of the public health emergency (PHE) related to the Coronavirus Disease 2019 (COVID-19) pandemic. The impending termination of FFCRAs continuous coverage rules and return to business as usual for Medicaid can be a nerve-wracking prospect for some enrollees. 3190 0 obj
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A PHE can be extended as many times as deemed necessary by the Secretary. Published: Feb 22, 2023. The end of the PHE will end this automatic enrollment and will require enrollees to prove eligibility. (Prior to the pandemic, states had to recheck each enrollees eligibility at least once per year, and disenroll people who were no longer eligible. The share of people who lack health insurance coverage dropped to 8.6% in 2021, matching the historic low in 2016, largely because of increases in Medicaid coverage, and to a lesser extent, increases in Marketplace coverage. There is a relatively new special enrollment period that allows people with household income up to 150% of the poverty level to enroll in coverage year-round, for as long as the enhanced subsidies remain in place (so at least through the end of 2025, and possibly longer if Congress grants another extension). The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. As states prepare to complete redeterminations for all Medicaid enrollees once the continuous enrollment provision ends, many may face significant operational challenges related to staffing shortages and outdated systems. The U.S. Department of Health and Human Services can extend the public health emergency in 90-day increments; it is currently set to end April 16. While the number of Medicaid enrollees who may be disenrolled during the unwinding period is highly uncertain, it is estimated that millions will lose coverage. With Republicans set to take control of House in January, Democrats see the move as the best and possibly last chance to fund some of their top health priorities, including policies that address the countrys worsening rates of maternal mortality that were left out of other packages passed this year. (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). Reducing the number of people who lose coverage for procedural reasons even though they remain eligible can also help to reduce the number of people who become uninsured. By law, public health emergencies are declared in 90-day increments. 3168 0 obj
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Republicans have long demanded an end to the Covid-era Medicaid policy that gives states more funding and bars them from kicking people off the rolls. For the most up-to-date news and . Enrollees may experience short-term changes in income or circumstances that make them temporarily ineligible. The latest extension will expire on April 16, 2022. These plans must describe how the state will prioritize renewals, how long the state plans to take to complete the renewals as well as the processes and strategies the state is considering or has adopted to reduce inappropriate coverage loss during the unwinding period. The Administration has stated that payments will resume either sixty days after the Supreme Court renders an opinion or June 30, whichever comes first. Importantly, these findings also show that large shares of enrollees (41% in the KFF analysis) reenroll in Medicaid after a period of time, and many after a period of uninsurance. In the Calendar Year (CY) 2022 Home Health Prospective Payment System (PPS) final rule, CMS snuck . If CMS determines a state is out of compliance with any applicable redetermination and reporting requirements, it can require the state to submit a corrective action plan and can require the state to suspend all or some terminations due to procedural reasons until the state takes appropriate corrective action. Democrats want to make that harder, but if they put too many restrictions on states ability to do that, Im not sure how the math would work out. There are also monthly reporting rules included in the law, designed to ensure transparency and accountability throughout the unwinding of the FFCRAs continuous coverage requirements. This enrollment growth more than 27% in a little over two and a half years was initially tied to the widespread job and income losses that affected millions of Americans early in the COVID pandemic. 7.8 million enrollees by March 2023. This additional match will be slowly wound down through 2023 and the federal match will be returned to what it had been prior to the PHE in January 2024. Home > Blog > Medicaid eligibility redeterminations will resume in 2023. As a result, in order for these waivers to continue, Congress must act and pass legislation making these waivers permanent. Total Medicaid/CHIP enrollment grew to 91.3 million in October 2022, an increase of 20.2 million or more than 28.5% from enrollment in February 2020 (Figure 1). States can take action to minimize the number of people who become uninsured due to Medicaid eligibility redeterminations after the PHE. Importantly, the legislation requires these reports be made publicly available. As part of a Covid-19 relief package passed in March 2020, states were barred from kicking people off Medicaid during the public health emergency in exchange for additional federal matching funds. The Consolidated Appropriations Act, 2023 (enacted in December 2022) has given states a specific date April 1, 2023 when they can begin terminating coverage for enrollees who are no longer eligible. CMS is ending the requirement that the supervising clinician be immediately available at the end of the calendar year where the PHE ends. %PDF-1.7
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Please provide your zip code to see plans in your area. Also fueling Democrats shift: pressure from state health officials who have been lobbying Congress to give them a set date when their Covid posture will formally end after years of last-minute extensions from the White House. To fully assess the impact of the unwinding will require broader outcome measures, such as continuity of coverage across Medicaid, CHIP, Marketplace, and employer coverage, gaps in coverage over time, and increases in the number of the uninsured, data that will not be available in the short-term. The state has to make a good-faith effort to find the person first. CNN . According to an Urban Institute analysis, about a third of the people losing Medicaid will be eligible for premium tax credits (subsidies) in the marketplace, while about two-thirds will be eligible for employer-sponsored coverage that meets the ACAs definition of affordable. The recently enacted Consolidated Appropriations Act includes additional reporting requirements for states and imposes penalties in the form of reduced federal matching payments for states that do not comply. Contact Us, 2023 Center for Children & Families (CCF) of the Georgetown University Health Policy Institute, McCourt School of Public Policy, Georgetown University | 600 New Jersey Ave. NW | Washington, DC 20001 | 202.784.3138, Georgetown Center for Children and Families Homepage, Percent of Children Covered by Medicaid/CHIP by Congressional District, 2018, Percent of Adults Covered by Medicaid/CHIP by Congressional District, 2018, renewed the COVID-related public health emergency. %%EOF
Under normal circumstances, they would have lost their Medicaid eligibility upon turning 65, as the, that allows for a six-month special enrollment period during which a Medicare-eligible person who loses Medicaid coverage can transition to Medicare without a late enrollment penalty. In the second quarter, that will drop to 5 percentage points. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. The COVID SEP ended in most states. A MACPAC analysis examined coverage transitions for adults and children who were disenrolled from Medicaid or separate CHIP (S-CHIP) and found that very few adults or children transitioned to federal Marketplace coverage, only 21% of children transitioned from Medicaid to S-CHIP, while 47% of children transitioned from S-CHIP to Medicaid (Figure 11). We are decoupling the Medicaid continuous eligibility policy from the Public Health Emergency. 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