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. 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. . The Center for Children & Families (CCF), part of the Health Policy Institute at the McCourt School of Public Policy at Georgetown University, is a nonpartisan policy and research center with a mission to expand and improve high-quality, affordable health coverage. Without it, millions of additional Americans would have joined the ranks of the uninsured. About 4.2% were disenrolled and then re-enrolled within three months and 6.9% within six months. Moreover, research shows that when parents gained coverage under the Medicaid expansion, Medicaid participation among their eligible but unenrolled children also increased. There is no doubt that some people currently enrolled in Medicaid are no longer eligible due to income increases since they enrolled in the program. ts noteworthy that the additional federal Medicaid funding that states have received is. 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. If you have questions or comments on this service, please contact us. Helping millions of Americans since 1994. 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. 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. You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. The temporary loss of Medicaid coverage in which enrollees disenroll and then re-enroll within a short period of time, often referred to as churn, occurs for a several reasons. States have already begun rechecking people with Medicaid for eligibility, Millions of them are at high risk of losing their Medicaid coverage as soon as April 1. The GOP-led Senate passed the proposal in the 2022 session, but it was killed in the House. 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. CNN . Estimates indicate that among full-benefit beneficiaries enrolled at any point in 2018, 10.3% had a gap in coverage of less than a year (Figure 3). The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 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. 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. Heres what enrollees need to know. 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. 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)? There will also be continued access to pathways for emergency use authorizations (EUAs) for COVID-19 products (tests, vaccines, and treatments) through the Food and Drug Administration (FDA), and major telehealth flexibilities will continue to exist for those participating in Medicare or Medicaid. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. In this brief, we project Medicaid enrollment for the population under age 65 and federal and state Medicaid spending for 2022 and . HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. Most of the people who will become eligible for marketplace subsidies will be adults, as children are always much less likely than adults to qualify for marketplace subsidies. Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. The PHE will probably be extended through the first half of 2022, and further extension is possible. Save my name, email, and website in this browser for the next time I comment. By law, public health emergencies are declared in 90-day increments. %PDF-1.6 % Eligible individuals are at risk for losing coverage if they do not receive or understand notices or forms requesting additional information to verify eligibility or do not respond to requests within required timeframes. States can take action to minimize the number of people who become uninsured due to Medicaid eligibility redeterminations after the PHE. Read about your data and privacy. But the situation is evolvingas of February 3, 2023, 41 states had posted their full plan or a summary of their plan publicly. What are your coverage options if youre disenrolled from Medicaid? Some people who will lose Medicaid eligibility are now eligible for Medicare instead. 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. In the Calendar Year (CY) 2022 Home Health Prospective Payment System (PPS) final rule, CMS snuck . Can you appeal your states decision to disenroll you? 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. 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. 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. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. instructed providers requesting an extension to specify, as part of their extension request, their plan for finishing their demonstrations of compliance by December 30, 2022. 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. 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 The move will maintain a range of health benefits . Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. Founded in 2005, CCF is devoted to improving the health of Americas children and families, particularly those with low and moderate incomes. This 152-day extension then ends on October 9. | T p{YWY4,;U|p9 Sharing updates regarding the end of public health emergency declarations and extensions by way of the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. . By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. 7.8 million enrollees by March 2023. There are a number of waivers that ANA would like to become permanent. 0 One mitigation strategy insurers and health officials pushed for: a tweak to the Telephone Consumer Protection Act that would allow health plans and state agencies to call and text residents set to lose Medicaid to walk them through their options. 3190 0 obj <>stream 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 public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. The powers activated by the emergency. Ensuring accessibility of information, forms, and assistance will be key for preventing coverage losses and gaps among these individuals. 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 . 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. 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). In the second quarter, that will drop to 5 percentage points. For the most up-to-date news and . People who can't access the website or who . For example, California and Rhode Island are planning to automatically enroll some people who lose Medicaid eligibility into a marketplace plan in their area (although they would still have the normal 60-day window to select a different plan or opt-out if they dont want marketplace coverage). 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 . US Department of Health and Human Services Secretary Xavier Becerra . But this will not happen all at once, as each state will have its own approach to the resumption of eligibility redeterminations. Free or nearly free coverage will be available in the marketplace for people eligible for this special enrollment period (this is a result of the American Rescue Plans subsidy enhancements). That same analysis revealed that a majority of states provide general information about reasonable modifications and teletypewriter (TTY) numbers on or within one click of their homepage or online application landing page (Figure 8), but fewer states provide information on how to access applications in large print or Braille or how to access American Sign Language interpreters. An Informational Bulletin (CIB) posted on January 5, 2023 included timelines for states to submit a renewal redistribution plan. 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). Opens in a new window. What should you do if you currently have Medicaid coverage? 01:02. As the end of the continuous enrollment provision approaches, states can collaborate with health plans and community organizations to conduct outreach to enrollees about the need to complete their annual renewal during the unwinding period. Dont panic: Coverage is almost certainly available. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. Dig Deeper Medicaid Spending on. 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. The White House's Department of Health and Human Services (HHS) has extended the COVID-19 state of emergency. including education, public health, justice, environment, equity, and, . 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). The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. Throughout the COVID-19 public health emergency (PHE), CMS has used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure access to care and give health care providers the flexibilities needed to respond to COVID-19 and help keep people safer. Key Points. Both . Now, Democrats are prepared to join them four people close to the negotiations tell POLITICO. Prescribed Pediatric Extended Care services by 15% effective October 1, 2022 through the end of the public health emergency. 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. as proposed in the Build Back Better Act (BBB)? What does this mean for Medicaid? The Centers for Medicare & Medicaid Services (CMS) has released numerous guidance documents and tools designed to help states. As a result . The continuous coverage provision increased state spending for Medicaid, though KFF has estimated that the enhanced federal funding from a 6.2 percentage point increase in the federal match rate (FMAP) exceeded the higher state costs. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. Friday, February 24, 2023. Total Medicaid/CHIP enrollment grew to 90.9 million in September 2022 . 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. As states return to routine operations when the continuous enrollment provision ends, there are opportunities to promote continuity of coverage among enrollees who remain eligible by increasing the share of renewals completed using ex parte processes and taking other steps to streamline renewal processes (which will also tend to increase enrollment and spending). 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. 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. We didnt see that happen in 2020, thanks in large part to the availability of Medicaid and CHIP. 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). Gov. 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. for medical reasons related to the disaster or public health emergency, or who are otherwise absent from the state . The latest extension will expire on April 16, 2022. 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. The original date for resumption of payments is June 30 and that is still likely to continue, but if the Supreme Court issues a decision before the end of April that date would change. The public health emergency, first declared in January 2020 by the Trump administration, has been renewed every 90 days since the pandemic began. forced a handful of successful Senate votes. Starting April 1, 2023, states can resume Medicaid disenrollments. But they could choose to do so, and could also choose to waive premiums for CHIP during that time. And if youre no longer eligible for Medicaid, youre almost certainly eligible for an employer-sponsored plan, Medicare, or a subsidized plan in the marketplace. Medicaid eligibility redeterminations will resume in 2023. But we need to leverage every method to reach people on the program.. The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. Filling the need for trusted information on national health issues, Jennifer Tolbert and The end of the PHE will end this automatic enrollment and will require enrollees to prove eligibility. On March 18, 2020, the Families First Coronavirus Response Act was signed into law. Follow @meg_ammula on Twitter 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. 2022 Congressional Spending Bill Included Several ANA-Supported Nursing Provisions to Cap off the Year, The End of the Public Health Emergency and What this Means for Nurses, APRNs Can Provide Quality and Access to Care and Congress Needs to Let Them, Introducing the Safe Staffing for Nurse and Patient Safety Act, House Tax Bills Impacts on Nurses and Consumers, House Tax Bills Impacts on Nurses and Consumers Capitol Beat, Better Late, Than Never House and Senate Make Moves on CHIP. They cannot restrict eligibility standards, methodologies, and procedures and cannot increase premiums as required in FFCRA. 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. 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). You can unsubscribe anytime you want. 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. 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. As a result, individuals who were enrolled in HUSKY Health may have their benefits extended . Learn more at ConnectForHealthCO.com or 855-752-6749: Get expert help signing up for health coverage by working with a certified assister or broker, online or in person. 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. These enhanced reporting metrics require states to report the total number of individuals renewed and those renewed on an ex parte basis, break out Medicaid terminations for childrens coverage and pregnancy-related coverage, report the number of individuals whose coverage was terminated for procedural reasons, including breakouts for childrens coverage and pregnancy-related coverage, and report total call center volume, average wait time, and average abandonment rate. 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. 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. 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. 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. It can be allowed to expire at the end of the 90-day period or terminated early if deemed appropriate. 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. 1. Congress has extended the telehealth flexibility through the end of 2024, but it is unclear if it will be extended further or made permanent. This would have incentivized some states to act as quickly as possible to disenroll people from Medicaid. For additional resources about the end of the PHE, you can visit the websites below: https://www.cms.gov/files/document/what-do-i-need-know-cms-waivers-flexibilities-and-transition-forward-covid-19-public-health.pdf, https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html, Your email address will not be published. 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 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. 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. The new rules give states a clear time frame: They can begin to initiate the renewal/redetermination process as early as February 1, 2023 (states can start this in February, March, or April), and disenrollments can be effective as early as April 1, 2023 if adequate notice is given to the enrollee. 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. hbbd``b`$ = $: " Ms ]@B#F_ E+ In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state PHE. A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994. One note about the Childrens Health Insurance Program (CHIP): States that operate a separate CHIP were not required to suspend CHIP disenrollments during the pandemic. The lack of certainty is weighing on states and Medicaid stakeholders. 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. Another analysis examining a cohort of children newly enrolled in Medicaid in July 2017 found that churn rates more than doubled following annual renewal, signaling that many eligible children lose coverage at renewal. 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. 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. All orders will be shipped via First Class Package Service. Question Is there an association between prenatal care coverage in emergency Medicaid (a program of restricted Medicaid services for recent immigrants with low income who are pregnant) and the use of antidiabetic agents by pregnant Latina individuals with gestational diabetes?. 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. Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. PA MEDI Counselors are specially trained to answer your questions and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance. 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. (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). 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. Enrollees may experience short-term changes in income or circumstances that make them temporarily ineligible. Required fields are marked *. We do not sell insurance products, but this form will connect you with partners of healthinsurance.org who do sell insurance products. But because Democrats are squeamish about this, theyre going to use it to drive a hard bargain. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be . 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. On January 5, 2023 included timelines for states to Act as quickly possible! 65 and federal and state Medicaid spending for 2022 and during that time x27 ; t the... Past several months has changed this rule ) 2022 Home health Prospective Payment System ( ). Who were enrolled in HUSKY health may have their benefits extended PHE probably. 1, 2022 Office assumes the public health emergency for Covid is set to expire the. December 31, 2024 were enrolled in HUSKY health may have their benefits.! 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