The latest extension will expire on April 16, 2022. In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state PHE. And some states that also offer additional state-funded subsidies allow people with higher incomes to enroll year-round. 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. Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. Medicaid enrollment increased by over 17 million from February 2020 to May 2022. Moreover, research shows that when parents gained coverage under the Medicaid expansion, Medicaid participation among their eligible but unenrolled children also increased. Follow @meg_ammula on Twitter The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. She has written dozens of opinions and educational pieces about theAffordable Care Actfor healthinsurance.org. CMS requires states to develop operational plans for how they will approach the unwinding process. A PHE can be extended as many times as deemed necessary by the Secretary. By preventing states from disenrolling people from coverage, the continuous enrollment provision has helped to preserve coverage during the pandemic. The public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision. Opens in a new window. 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. Yet Congress signaled change in the final days of 2022. They cannot restrict eligibility standards, methodologies, and procedures and cannot increase premiums as required in FFCRA. There is normally quite a bit of turnover in the Medicaid program, with some people losing eligibility each month. The Centers for Medicare & Medicaid Services (CMS) implemented several interim final rules during the PHE. 0 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. 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. 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. 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. So where does this leave the continuous enrollment requirement? If BBB had been enacted in December, states would have had three months to get ready. Healthcare Dive reports that the majority of people with Medicaid do not know that their coverage could end when the public health emergency ends. However, we know Congress is considering delinking the FMAP bump and continuous enrollment and other maintenance of effort provisions from the PHE. A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994. Home > Blog > Medicaid eligibility redeterminations will resume in 2023. 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. 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. 1. prepare for the eventual end of the COVID-19 public health emergency (PHE), including a State Health Official Letter, Promoting Continuity 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. 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. According to a survey of non-profit, safety net health plans that participate in Medicaid, states are partnering with these MCOs in multiple ways. The move will maintain a range of health benefits . Published: Feb 22, 2023. A trusted independent health insurance guide since 1994. Required fields are marked *. 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. 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. On January 30, the Biden Administration announced May 11, 2023, as the targeted end date for the national public health emergency (PHE) declarations implemented during the COVID-19 pandemic. Medicaid and CHIP Services Information for People Receiving Services English Espaol In response to the COVID-19 pandemic, the federal government declared a public health emergency (PHE) and passed a law that allowed you to automatically keep your Medicaid coverage (continuous Medicaid). That emergency is set to end in May. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. 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. (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). Twenty-two states complete less than 50% of renewals on an ex parte basis, including 11 states where less than 25% of renewals are completed using ex parte processes (Figure 5). 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. This article has also been updated to note that the American Rescue Plans subsidy enhancements have been extended by the Inflation Reduction Act. 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 . Any information we provide is limited to those plans we do offer in your area. Friday, February 24, 2023. CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment. As of March 2022, the Medicaid expansion had extended coverage to 8 million low-income adults who would not otherwise have been eligible for Medicaid without it. 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. Medical personnel prepare to prone a Covid-19 patient at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles. Click Check Out Now. 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. 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. Under normal circumstances, they would have lost their Medicaid eligibility upon turning 65, as the, that allows for a six-month special enrollment period during which a Medicare-eligible person who loses Medicaid coverage can transition to Medicare without a late enrollment penalty. A recent analysis of churn rates among children found that while churn rates increased among children of all racial and ethnic groups, the increase was largest for Hispanic children, suggesting they face greater barriers to maintaining coverage. HHS says it plans to extend Covid-19 public health emergency - POLITICO Health Care HHS says it plans to extend Covid-19 public health emergency An extension would ensure expanded. The resumption of eligibility redeterminations is no longer linked to end of public health emergency. Its clear their support and openness to it is contingent on reinvesting the savings back into Medicaid in a permanent way. For the first quarter of 2023, states will continue to get the 6.2 percentage point boost that theyve been receiving throughout the pandemic. 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. The Biden administration has extended the public health emergency (PHE) for 90 days, from October 18, 2021 through January 16, 2022. endstream endobj startxref You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. 3190 0 obj <>stream The COVID SEP ended in most states. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. 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. 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. This process, which is frequently referred to as unwinding, is resuming after three years of being paused, so many current Medicaid enrollees have never experienced routine eligibility redeterminations. We do not sell insurance products, but this form will connect you with partners of healthinsurance.org who do sell insurance products. The lack of certainty is weighing on states and Medicaid stakeholders. For a person who is no longer Medicaid-eligible under normal rules, Medicaid coverage can end as early as April 1, 2023. You can share your story about the impact of the Public Health Emergency HERE. Please contact Medicare.gov or 1800 MEDICARE to get information on all of your options. 3. States will be eligible for the phase-down of the enhanced FMAP (6.2 percentage points through March 2023; 5 percentage points through June 2023; 2.5 percentage points through September 2023 and 1.5 percentage points through December 2023) if they comply with certain rules. 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. But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. 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 current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. What if your income has increased to a level thats no longer Medicaid-eligible? Findings This cohort study of 4869 Latina patients with gestational (n = 2907) or preexisting diabetes (n . Nursing school is expensive and as a result roughly of nursing students take out federal student loans to help pay for school. 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. You can unsubscribe anytime you want. 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). People using this window can, If youre eligible for Medicare, youll have. Because of specific Congressional action many of the telehealth flexibilities authorized under the PHE will continue through the end of 2024. 1. 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. Founded in 2005, CCF is devoted to improving the health of Americas children and families, particularly those with low and moderate incomes. 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). But the overall pace of Medicaid eligibility redeterminations and disenrollments will vary considerably from one state to another. The PHE has been in place since January 27, 2020, and renewed throughout the pandemic. Without other action, states can start disenrolling people beginning May 1, 2022. Heres what enrollees need to know. In the second quarter, that will drop to 5 percentage points. Share on Facebook. Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. 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. 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. hb```+@(1IAcfK9[<6k`cts``NaPsg@uQVH(pGS 4)NtQlqV~T~(plUUv=@\8\:\4?LqB d 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. Share this: . | Jae C. Hong/AP Photo. Verify that your information is correct and select Place My Order. 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. Without it, millions of additional Americans would have joined the ranks of the uninsured. Doing so would decrease federal spending on Medicaid and allow states to remove ineligible people from the program, saving the government tens of billions of dollars. 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. 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