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. However, the Administrations superseding debt forgiveness program is still pending in the courts. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. For system readiness reporting, states are required to demonstrate that their eligibility systems for processing renewals are functioning correctly, particularly since states have not been conducting normal renewals while the continuous enrollment provision has been in effect. Republicans pushing for the deal have also been reminding Democrats that their original Build Back Better legislative package which ultimately became the Inflation Reduction Act and passed this year after being significantly whittled down included a wind-down of the public health emergency as a pay-for. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. The Biden administration on Friday extended the Covid-19 public health emergency for another three months. But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage. Collectively, these metrics are designed to demonstrate states progress towards restoring timely application processing and initiating and completing renewals of eligibility for all Medicaid and CHIP enrollees and can assist with monitoring the unwinding process to identify problems as they occur. According to a KFF survey conducted in January 2022, states were taking a variety of steps to prepare for the end of the continuous enrollment provision (Figure 4). The Biden administration announced its intention to end the federal public health emergency on May 11, 2023. 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). Any information we provide is limited to those plans we do offer in your area. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). 541 0 obj <>stream Republicans have long called for ending the public health emergency for Covid-19 and have forced a handful of successful Senate votes that were then blocked in the House. CMS is referring to the return to normal eligibility redeterminations and disenrollments as a Medicaid and CHIP unwinding.. Dont panic: Coverage is almost certainly available. ANA has worked with the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) on making waivers permanent, but CMS believes that they do not have the authority to make any additional waivers permanent. There is normally quite a bit of turnover in the Medicaid program, with some people losing eligibility each month. However, there will also be current enrollees who are determined to be no longer be eligible for Medicaid, but who may be eligible for ACA marketplace or other coverage. Fortunately, Medicaid was able to step in and provide health coverage when people lost their income. Tate Reeves, after months of resistance, asks lawmakers to pass postpartum Medicaid extension by Bobby Harrison February 26, 2023 February 26, 2023. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. The Biden administration has extended the public health emergency (PHE) for 90 days, from October 18, 2021 through January 16, 2022. You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. 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. If youre currently enrolled in Medicaid, its a good idea to familiarize yourself with your states eligibility rules, and figure out whether youd be eligible if you were to apply today, with your current circumstances and income. Find out how much financial help you may qualify for. 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). What does this mean for Medicaid? How states approach the unwinding process will have implications for the ability of eligible individuals to retain coverage and those who are no longer eligible to transition to other coverage. 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. There are millions of people who became eligible for Medicaid at some point since March 2020, and are still enrolled in Medicaid even though they would not be determined eligible if they were to apply today. Heres what enrollees need to know. As a result . The public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. Your email address will not be published. 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). 3. But they could choose to do so, and could also choose to waive premiums for CHIP during that time. That means that this will end on December 31 of this year. But if the answer is no, be prepared for a coverage termination notice at some point after the end of March 2023. The ARP is still making premiums more affordable. Now, Democrats are prepared to join them four people close to the negotiations tell POLITICO. But because Democrats are squeamish about this, theyre going to use it to drive a hard bargain. Primarily due to the continuous enrollment provision, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. Some states suspended renewals as they implemented the continuous enrollment provision and made other COVID-related adjustments to operations. 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. I was, frankly, a little surprised that Dems were not more willing to cut a deal on this earlier, a health industry lobbyist familiar with negotiations noted to POLITICO. The lower estimate accounts for factors, such as new people enrolling in the program as well as people disenrolling then re-enrolling in the program within the year, while the higher estimate reflects total disenrollment and does not account for churn or new enrollees. Helping millions of Americans since 1994. hbbd``b`$ = $: " Ms ]@B#F_ E+ Enrollees may experience short-term changes in income or circumstances that make them temporarily ineligible. 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). States that fail to comply with these reporting requirements face a reduction in federal medical assistance percentage (FMAP) of up to one percentage point for the quarter in which the requirements are not met. As of January 10, 2023, CMS had approved a total of 158 waivers for 41 states (Figure 6). 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. A nationwide public health emergency is in effect. Many of these waivers and broad . The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. This increase is in large part due to the extension of the COVID-19 pandemic public health emergency (PHE).2 Due to the maintenance of effort requirements under the Families First Coronavirus Response Act (FFCRA), which has precluded most forms of involuntary disenrollment from Based on illustrative scenariosa 5% decline in total enrollment and a 13% decline in enrollmentKFF estimates that between 5.3 million and 14.2 million people will lose Medicaid coverage during the 12-month unwinding period (Figure 2). Many states have continued to send out these renewal notifications and information requests throughout the pandemic (nearly all states have been conducting automatic (ex parte) renewals when possible, and more than half the states have also been sending renewal forms to enrollees). This would have incentivized some states to act as quickly as possible to disenroll people from Medicaid. HHS has laid out some basic guidelines, and states have four general options in terms of how they handle the unwinding of the continuous coverage protocols and the return to regular eligibility redeterminations for the entire Medicaid population: If youre still eligible for Medicaid under your states rules, youll be able to keep your coverage. The resumption of eligibility redeterminations is no longer linked to end of public health emergency. The lack of certainty is weighing on states and Medicaid stakeholders. Heres what enrollees need to know. For the most up-to-date news and . This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made, and summarizes the flexibilities triggered by each in the following. 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. 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. The latest extension will expire on April 16, 2022. What if your income has increased to a level thats no longer Medicaid-eligible? Opens in a new window. Even though Congress could still enact some version of the BBB provisions relating to the unwinding of the continuous enrollment requirement, some states would find an April 1, 2022 renewal start date challenging. Omnibus spending bill allows states to resume Medicaid eligibility redeterminations in April. 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. An analysis of state Medicaid websites found that while a majority of states translate their online application landing page or PDF application into other languages, most only provide Spanish translations (Figure 7). That will resume in April 2023.). Medicaid enrollment increased by over 17 million from February 2020 to May 2022. A majority of responding MCOs reported that they are sending updated member contact information to their state; nearly all said their state is planning to provide monthly files on members for whom the state is initiating the renewal process and more than half indicated that information would include members who have not submitted renewal forms and are at risk of losing coverage; and more than half of plans reported their state is planning to provide periodic files indicating members whose coverage has been terminated . The Biden administration appears headed toward extending the COVID-19 public health emergency for another three months, allowing special powers and programs to continue past the midterm election. And although the Biden administration had promised states at least a 60-day notice before the end of the PHE, states had noted that it was still proving very difficult to plan for the resumption of Medicaid eligibility redeterminations given the uncertain timeframe. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be significant. 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. If providers finish submitting their evidence by that date, then the Department would be in a position to verify the evidence and confirm compliance in early 2023. The Administration's plan is to end the COVID-19 public health emergency (PHE) on May 11, 2023. The end of the PHE will end this automatic enrollment and will require enrollees to prove eligibility. Section 319 of the Public Health Service Act gives the federal HHS Secretary the authority to make such a declaration when a severe disease . (PHE) ends. However, while the new data reporting requirements are useful, they will not provide a complete picture of how the unwinding is proceeding and whether certain groups face barriers to maintaining coverage. 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. But during the PHE, these individuals have not had their Medicaid coverage terminated. In a May 2022 letter to governors, HHS noted We strongly encourage your state to use the entire 12-month unwinding period to put in place processes that will prevent terminations of coverage for individuals still eligible for Medicaid as your state works through its pending eligibility actions.. Congress has extended the telehealth flexibility through the end of 2024, but it is unclear if it will be extended further or made permanent. In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state PHE. 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). As COVID-19 becomes less of a threat and the federal government's public health emergency ends, states will restart yearly Medicaid and Children's Health Insurance Program (CHIP) eligibility reviews beginning April 1, 2023. Yet Congress signaled change in the final days of 2022. Follow @meg_ammula on Twitter 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. 3190 0 obj <>stream Its only a pay-for because youd be removing people from Medicaid, said Brian Blase, the president of the conservative Paragon Health institute and a former senior Senate Republican aide. But the continued enrollment growth in Medicaid is primarily due to the fact that the Families First Coronavirus Response Act (FFCRA), enacted in March 2020, has been providing states with additional federal funding for their Medicaid programs, as long as they dont disenroll people from Medicaid during the COVID public health emergency (PHE) period. Were providing certainty to states and giving them a gradual stream of funding and guardrail requirements that protect people. And if youve moved or your contact information has changed since you first enrolled in Medicaid, make sure the state has your current contact information on file. Friday, February 24, 2023. Two key public health reauthorizationsthe Pandemic and All-Hazards Preparedness Act (PAHPA) and the President's Emergency Plan for AIDS Relief (PEPFAR)are due for renewal in 2023. 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