But the situation is evolvingas of February 3, 2023, 41 states had posted their full plan or a summary of their plan publicly. 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. But there are very real concerns that many people who are actually still eligible for Medicaid might lose their coverage due to a lack of understanding of the process, onerous paper-based eligibility redetermination systems, unstable housing/communication situations, etc. Lawmakers have struck an agreement to move the end of its Medicaid rules up to April 1, which would allow states to begin removing people from the rolls who no longer qualify, usually because their income has increased. including education, public health, justice, environment, equity, and, . %%EOF CNN . Primarily due to the continuous enrollment provision, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped. 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. Together, these findings suggest that individuals face barriers moving from Medicaid to other coverage programs, including S-CHIP. 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. At that time, they will be required to conduct a full renewal based on current circumstances before disenrolling anyone. Because of specific Congressional action many of the telehealth flexibilities authorized under the PHE will continue through the end of 2024. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. For the most up-to-date news and . Many of these waivers and broad . 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. Some people who will lose Medicaid eligibility are now eligible for Medicare instead. Without it, millions of additional Americans would have joined the ranks of the uninsured. Verify that your information is correct and select Place My Order. The supervision requirements are also ending but are not based on the 152-day extension. 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. Meghana Ammula The COVID-19 pandemic cast a spotlight on the importance of the various safety net systems that the U.S. has in place. 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. The end of the PHE will end this automatic enrollment and will require enrollees to prove eligibility. 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. Can you appeal your states decision to disenroll you? 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. Please provide your zip code to see plans in your area. 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. She has written dozens of opinions and educational pieces about theAffordable Care Actfor healthinsurance.org. 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. Under the tentative deal, much of the money saved would go to two Medicaid policies Democrats have long sought: a year of postpartum coverage for low-income moms in states that dont already offer it and a year of continuous coverage provisions for children at risk of losing health insurance. 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. Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. . during which you can transition to Medicare without any late enrollment penalties. 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. the federal government declared a public health emergency (PHE). 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. Dig Deeper Medicaid Spending on. the extra cost that states have incurred to cover the FFCRA-related enrollment growth. 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). 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. | T p{YWY4,;U|p9 Gov. Helping millions of Americans since 1994. Its clear their support and openness to it is contingent on reinvesting the savings back into Medicaid in a permanent way. 528 0 obj <>/Filter/FlateDecode/ID[<3C6513E815B48242A21C94DD62711375>]/Index[506 36]/Info 505 0 R/Length 108/Prev 319214/Root 507 0 R/Size 542/Type/XRef/W[1 3 1]>>stream We do not sell insurance products, but this form will connect you with partners of healthinsurance.org who do sell insurance products. 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. (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.). We didnt see that happen in 2020, thanks in large part to the availability of Medicaid and CHIP. 3190 0 obj <>stream Churn can result in access barriers as well as additional administrative costs. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. As a result . 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. 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. Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . All orders will be shipped via First Class Package Service. For enrollment reporting, states will provide baseline data at the start of the unwinding period related to applications, enrollment, estimated timeframe for completing initiated renewals, and fair hearings, and then states will submit monthly reports that will be used to monitor these metrics throughout the unwinding period (Figure 10). 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. Were providing certainty to states and giving them a gradual stream of funding and guardrail requirements that protect people. CLARIFICATION: This report has been updated to clarify that the Congressional Budget Office expects the public health emergency for Covid will expire in July, barring another extension. Without other action, states can start disenrolling people beginning May 1, 2022. 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. endstream endobj startxref What are your coverage options if youre disenrolled from Medicaid? In some states, it will be the most significant enrollment action in the 50+ year history of Medicaid. For the first quarter of 2023, states will continue to get the 6.2 percentage point boost that theyve been receiving throughout the pandemic. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). But this will not happen all at once, as each state will have its own approach to the resumption of eligibility redeterminations. March 31, 2023 is the last day that states have to maintain the continuous coverage rules that have been in place since March 2020. For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. The ARP is still making premiums more affordable. They cannot restrict eligibility standards, methodologies, and procedures and cannot increase premiums as required in FFCRA. 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 . By preventing states from disenrolling people from coverage, the continuous enrollment provision has helped to preserve coverage during the pandemic. Overall enrollment increases may reflect economic conditions related to the pandemic, the adoption of the Medicaid expansion under the Affordable Care Act in several states (NE, MO, OK), as well as the continuous enrollment provision included in the Families First Coronavirus Response Act (FFCRA). Click Check Out Now. %%EOF Lastly, states are required to maintain up to date contact information and attempt to contact enrollees prior to disenrollment when mail is returned. 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. Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work. Some states suspended renewals as they implemented the continuous enrollment provision and made other COVID-related adjustments to operations. Under normal circumstances, they would have lost their Medicaid eligibility upon turning 65, as the Medicaid eligibility rules are much different (and include asset tests) for people 65 and older. 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. CMS requires states to develop operational plans for how they will approach the unwinding process. 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. The Biden administration on Friday extended the Covid-19 public health emergency for another three months. 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 . 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 Biden administration announced its intention to end the federal public health emergency on May 11, 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. This would have incentivized some states to act as quickly as possible to disenroll people from Medicaid. 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. The question is: Can they get enough wins to take the political sting off allowing states to kick people off the rolls?. for medical reasons related to the disaster or public health emergency, or who are otherwise absent from the state . 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. There are a number of waivers that ANA would like to become permanent. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. 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. Omnibus spending bill allows states to resume Medicaid eligibility redeterminations in April. The Biden administration extended the U.S. coronavirus public health emergency, now more than two years old, for another 90 days on Wednesday. Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. 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. What if your income has increased to a level thats no longer Medicaid-eligible? This 152-day extension then ends on October 9. Congressional negotiators are set to unveil the text of the 2023 omnibus spending bill on Monday. However, the Administrations superseding debt forgiveness program is still pending in the courts. 3168 0 obj <> endobj 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. Current emergencies 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 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 Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. And since coverage cannot be backdated, its essential to ensure that youre covered before any medical needs arise. 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. 3. In the Calendar Year (CY) 2022 Home Health Prospective Payment System (PPS) final rule, CMS snuck . 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. 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 . 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. The PHE will probably be extended through the first half of 2022, and further extension is possible. But they could choose to do so, and could also choose to waive premiums for CHIP during that time. %PDF-1.6 % Preparing for the End of COVID-19: Return to Regular Renewals . The Congressional Budget Office assumes the public health emergency for Covid will expire in July barring another extension by the Biden administration. The Consolidated Appropriations Act, 2023 decouples the Medicaid continuous enrollment provision from the PHE and terminates this provision on March 31, 2023. hbbd``b`$ = $: " Ms ]@B#F_ E+ b1Y nact1X i"hi9!0 "@,f W1LL\vL1.ez,t_M8cp]4XfiFfm m2=sX1g`Vw? 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. 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. forced a handful of successful Senate votes. 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. So HHS has finalized a rule change 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. But the Consolidated Appropriations Act, 2023 ensures that states continue to receive at least some additional federal Medicaid funding throughout 2023. 0 Plus, if you funnel people into subsidized Obamacare plans, those are more expensive than Medicaid.. Both . You can share your story about the impact of the Public Health Emergency HERE. 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. Theres always a risk of scams and abuses should that happen, Rollins cautioned, arguing that the calling and texting ban should only be lifted for the period of the Medicaid redeterminations. About 4.2% were disenrolled and then re-enrolled within three months and 6.9% within six months. 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). 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. 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. 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). 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. 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. 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. 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. 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 It can be allowed to expire at the end of the 90-day period or terminated early if deemed appropriate. 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). (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). If you have questions or comments on this service, please contact us. 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. Medicaid enrollees should pay close attention to redetermination notices that they may receive once normal eligibility redeterminations resume. According to a survey of non-profit, safety net health plans that participate in Medicaid, states are partnering with these MCOs in multiple ways. People who can't access the website or who . Filling the need for trusted information on national health issues, Jennifer Tolbert and But because Democrats are squeamish about this, theyre going to use it to drive a hard bargain. The powers activated by the emergency. The main waivers are: The end of the PHE will also have an effect on the Medicaid program. Alternatively, some people who remain eligible may face barriers to maintaining coverage due to renewal processes and periodic eligibility checks. 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. 1. prepare for the eventual end of the COVID-19 public health emergency (PHE), including a State Health Official Letter, Promoting Continuity The Biden Administration announced on January 30 that the COVID-19 national public health emergency (PHE) will end on May 11, 2023. . 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. By law, public health emergencies are declared in 90-day increments. Your email address will not be published. Would love your thoughts, please comment. The PA MEDI Helpline is available at 1-800-783-7067 from 8 a.m. to 5 p.m. Monday-Friday. Key Points. 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. HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. 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. The most recent draft of the BBB would have begun to phase out the enhanced FMAP in the second and third quarters of the year (April September 2022) and, if it becomes law as written, states would be allowed to restart renewals as of April 1st. What are your options if youre no longer eligible for Medicaid? 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. expected to be extended again in January 2023, Medicaid eligibility redetermination process, very difficult to plan for the resumption of Medicaid eligibility redeterminations, Childrens Health Insurance Program (CHIP), were not required to suspend CHIP disenrollments during the pandemic, Texas is an example of a state taking this approach, Virginia is an example of a state taking this approach, Tennessee is an example of a state taking this approach, Georgia is an example of a state taking this approach, continued to send out these renewal notifications and information requests, Medicaid and CHIP eligibility for children extend to significantly higher income ranges, Medicaid eligibility rules are much different (and include asset tests) for people 65 and older, elect to have their Medicare coverage retroactive to the day after their Medicaid ended, But it will start to apply again as of June 10, 2023, health insurance marketplace in your state, pleasantly surprised to see how affordable the coverage will be, read this article about strategies for avoiding the coverage gap, the income levels that will make you eligible, American Rescue Plans subsidy enhancements. 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