CMS is referring to the return to normal eligibility redeterminations and disenrollments as a Medicaid and CHIP unwinding.. Its noteworthy that the additional federal Medicaid funding that states have received is more than double the extra cost that states have incurred to cover the FFCRA-related enrollment growth. Democrats are on the record as being open to that, a Senate Republican aide told POLITICO. The Biden administration has been under mounting pressure to declare the public health emergency over, with 25 Republican governors asking the president to end it in a letter on Monday, which. 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. 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. What are your coverage options if youre disenrolled from Medicaid? Required fields are marked *. 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. Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270, www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff. When the continuous enrollment provision ends and states resume redeterminations and disenrollments, certain individuals will be at increased risk of losing Medicaid coverage or experiencing a gap in coverage due to barriers completing the renewal process, even if they remain eligible for coverage. 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). 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. Your email address will not be published. 3. The main waivers are: The end of the PHE will also have an effect on the Medicaid program. Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. During the PHE, Medicaid agencies have not disenrolled most members, even if someone's eligibility changed . Heres what enrollees need to know. The Biden administration has extended the public health emergency (PHE) for 90 days, from October 18, 2021 through January 16, 2022. Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. 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. We didnt see that happen in 2020, thanks in large part to the availability of Medicaid and CHIP. First, the maintenance of effort provisions in the Families First Coronavirus Response Act remain in effect until January 31, 2022 (the end of the month after the PHE ends). This provision requires states to provide continuous coverage for Medicaid enrollees until the end of the month in which the public health emergency (PHE) ends in order to receive enhanced federal funding. The Consolidated Appropriations Act, 2023 decouples the Medicaid continuous enrollment provision from the PHE and terminates this provision on March 31, 2023. The Department of Health and Human Services (HHS) has extended the public health emergency eight times and is currently set to expire in April 2022. 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. 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. 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. 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. 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. By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. Some people who will lose Medicaid eligibility are now eligible for Medicare instead. A proposed rule, released on September 7, 2022, seeks to streamline enrollment and renewal processes in the future by applying the same rules for MAGI and non-MAGI populations, including limiting renewals to once per year, prohibiting in-person interviews and requiring the use of prepopulated renewal forms. 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. Verify that your information is correct and select Place My Order. Now, Democrats are prepared to join them four people close to the negotiations tell POLITICO. If youve recently submitted renewal information to your state and its clear that youre still eligible, your coverage will continue as usual until your next renewal period. The White House's Department of Health and Human Services (HHS) has extended the COVID-19 state of emergency. However, waivers that allowed advanced practice registered nurses (APRNs) to practice at the top of their license will expire on October 9 absent further Congressional action. Follow @meg_ammula on Twitter Total Medicaid/CHIP enrollment grew to 90.9 million in September 2022 . 01:02. Share this: . A PHE can be extended as many times as deemed necessary by the Secretary. HHS Secretary Xavier Becerra last renewed the COVID public health emergency on Jan. 11, 2023. Get an email every time we post. By law, public health emergencies are declared in 90-day increments. Dont panic: Coverage is almost certainly available. 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 . Amid tense arguments about how to spend the savings from the expedited end to the Medicaid portion of the PHE, lawmakers have also struggled over whether and how to set up guardrails to protect people who make slightly too much to qualify for Medicaid from being left without a private health insurance plan they can afford in 2023. We are decoupling the Medicaid continuous eligibility policy from the Public Health Emergency. Helping millions of Americans since 1994. The COVID public health emergency (PHE) is expected to be extended again in January 2023, but the omnibus bill de-links the resumption of Medicaid eligibility redeterminations from the PHE, and allows states to start processing eligibility determinations as of April 1, 2023. 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. 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. EDITORS NOTE: This article was first posted in March 2022 but has been updated to reflect the passage of the Consolidated Appropriations Act, 2023 (the omnibus spending bill). For the first quarter of 2023, states will continue to get the 6.2 percentage point boost that theyve been receiving throughout the pandemic. The main point to keep in mind is that the opportunity to transition to new coverage, from an employer, Medicare, or through the marketplace, is time-limited, although the unwinding SEP described above (announced in late January 2023) gives people significantly more flexibility in terms of being able to enroll in a plan through HealthCare.gov after losing Medicaid during the 16-month window that starts March 31, 2023. For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. 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). Gov. But enrollment has trended upward throughout the pandemic, without the normal disenrollments that previously stemmed from the regular Medicaid eligibility redetermination process. hb```+@(1IAcfK9[<6k`cts``NaPsg@uQVH(pGS 4)NtQlqV~T~(plUUv=@\8\:\4?LqB d Importantly, the legislation requires these reports be made publicly available. The state has to make a good-faith effort to find the person first. 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 supervision requirements are also ending but are not based on the 152-day extension. Heres what enrollees need to know. Prescribed Pediatric Extended Care services by 15% effective October 1, 2022 through the end of the public health emergency. 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. CMS guidance about the unwinding of the continuous enrollment provision stresses the importance of conducting outreach to enrollees to update contact information and provides strategies for partnering with other organizations to increase the likelihood that enrollee addresses and phone numbers are up to date. That is now expected to happen in May 2023. Lawmakers and staff have been scrambling for weeks to find ways to pay for a slew of health care programs, such as permanent telehealth flexibility, providing longer Medicaid coverage for new mothers and avoiding scheduled cuts to doctors payments, prompting formerly resistant Democratic members to take a fresh look at moving up the end-date of the Covid-19 Medicaid policy by at least three months to April 1. What do these three possible scenarios mean for Medicaid if Congress does not take additional action as proposed in the Build Back Better Act (BBB)? uyx'tE!~YV.v.wDO @:Z98-PtinB*[Elrcr[b8B9NX5IR'[UC.ok"zf3itMAiP((ISh. While the share of individuals disenrolled across states will vary due to differences in how states prioritize renewals, it is expected that the groups that experienced the most growth due to the continuous enrollment provisionACA expansion adults, other adults, and childrenwill experience the largest enrollment declines. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. You can share your story about the impact of the Public Health Emergency HERE. According to a survey of non-profit, safety net health plans that participate in Medicaid, states are partnering with these MCOs in multiple ways. If BBB had been enacted in December, states would have had three months to get ready. the extra cost that states have incurred to cover the FFCRA-related enrollment growth. The purpose of this bulletin is to inform providers that the federal public health emergency (PHE) was extended on January 14, 2022, and will now last until April 16, 2022. But the overall pace of Medicaid eligibility redeterminations and disenrollments will vary considerably from one state to another. Share on Facebook. The overriding thing state Medicaid agencies want is certainty about what is coming, Jack Rollins, the director of federal policy for the National Association of Medicaid Directors, told POLITICO. Regardless of timing, the lifting of the continuous enrollment requirement will have a substantial impact on states and Medicaid enrollees, particularly in states that have been unable to renew coverage automatically for a significant portion of enrollees. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. March 31, 2023 is the last day that states have to maintain the continuous coverage rules that have been in place since March 2020. 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. That will help us make the concrete plans necessary to make sure this happens in an orderly fashion.. As of January 10, 2023, CMS had approved a total of 158 waivers for 41 states (Figure 6). Starting April 1, 2023, states can resume Medicaid disenrollments. %%EOF So the Consolidated Appropriations Act, 2023 does require states to use the U.S. Post Offices change of address database and/or state Department of Health and Human Services data to ensure that the state has updated contact information for people whose coverage eligibility is being redetermined. 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. In some states, it will be the most significant enrollment action in the 50+ year history of Medicaid. This window, If you do not have access to an employer-sponsored health plan, you can apply for a premium tax credit (subsidy) to offset the cost of coverage in the, The subsidies that are currently available in the marketplace are particularly generous, thanks to the, If youre in a state that hasnt expanded Medicaid under the ACA and your income is below the poverty level, you may find yourself in the. 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. Some states suspended renewals as they implemented the continuous enrollment provision and made other COVID-related adjustments to operations. 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. States can take action to minimize the number of people who become uninsured due to Medicaid eligibility redeterminations after the PHE. If you have questions or comments on this service, please contact us. How many people will lose Medicaid coverage when the continuous coverage requirement ends? As a result . assuming the administration keeps its promise, Unwinding Wednesday #22: Updates to 50-State Tracker with One Month Until Unwinding Start Date, Center for Renewing America Budget Plan Would Cut Federal Medicaid Spending by One-Third, Repeal Affordable Care Acts Coverage Expansions, Federal Medicaid Expansion Incentives Offer Another Tool for States to Continue Coverage as Pandemic-Era Medicaid Rules End. She has written dozens of opinions and educational pieces about theAffordable Care Actfor healthinsurance.org. Any information we provide is limited to those plans we do offer in your area. This article has also been updated to note that the American Rescue Plans subsidy enhancements have been extended by the Inflation Reduction Act. Both . The Congressional Budget Office assumes the public health emergency for Covid will expire in July barring another extension by the Biden administration. The PHE has been in place since January 27, 2020, and renewed throughout the pandemic. The U.S. Department of Health and Human Services (HHS) must renew the federal public health emergency (PHE) related to COVID-19 every 90 days to maintain certain health care flexibilities and waivers. Opens in a new window. Or maybe your circumstances have changed perhaps your income is the same but you have fewer people in your household and your income now puts you at a higher percentage of the poverty level. | Jae C. Hong/AP Photo. But we need to leverage every method to reach people on the program.. Nursing school is expensive and as a result roughly of nursing students take out federal student loans to help pay for school. Yet Congress signaled change in the final days of 2022. The Biden administration on Friday extended the Covid-19 public health emergency for another three months. HHS projects that approximately 15 million people will lose eligibility for Medicaid once the normal eligibility redetermination process resumes. for medical reasons related to the disaster or public health emergency, or who are otherwise absent from the state . 2716, the Consolidated . Of the 42 states processing ex parte renewals for MAGI groups (people whose eligibility is based on modified adjusted gross income), only 11 states report completing 50% or more of renewals using ex parte processes. You may have to submit documentation to the state to prove your ongoing eligibility, so pay close attention to any requests for information that you receive. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be . People using this window can, If youre eligible for Medicare, youll have. That means that this will end on December 31 of this year. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. The end of the PHE will end this automatic enrollment and will require enrollees to prove eligibility. But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage. Key Points. 3179 0 obj <>/Filter/FlateDecode/ID[<20F5AF77DB63DC49B2341D6107722670>]/Index[3168 23]/Info 3167 0 R/Length 69/Prev 482993/Root 3169 0 R/Size 3191/Type/XRef/W[1 2 1]>>stream Without other action, states can start disenrolling people beginning May 1, 2022. 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. This brief describes 10 key points about the unwinding of the Medicaid continuous enrollment requirement, highlighting data and analyses that can inform the unwinding process as well as recent legislation and guidance issued by the Centers for Medicare and Medicaid Services (CMS) to help states prepare for the end of the continuous enrollment provision. Medicaid provides coverage to a vast. MOUNT VERNON As the COVID-19 public health emergency nears its end, eligible families and individuals risk losing Medicaid coverage and SNAP food stamp benefits through a process often called "unwinding." "The changes that are upon us do not necessarily affect everybody, but a lot of people accustomed to getting Medicaid or SNAP, if . HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. 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