HHS has laid out some basic guidelines, and states have four general options in terms of how they handle the unwinding of the continuous coverage protocols and the return to regular eligibility redeterminations for the entire Medicaid population: If youre still eligible for Medicaid under your states rules, youll be able to keep your coverage. 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. Additionally, nearly six in ten assister programs said they had proactively reached out to their state to explore ways to help consumers; supported the state sharing contact information with them on individuals who need to renew their Medicaid coverage; and were planning to recontact Medicaid clients to update their contact information. 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). On March 18, 2020, the Families First Coronavirus Response Act was signed into law. including education, public health, justice, environment, equity, and, . 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 . 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enrollment provision ends, many may face significant operational challenges related to staffing shortages and outdated systems. 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. However, in many states, the share of renewals completed on an ex parte basis is low. 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. If providers finish submitting their evidence by that date, then the Department would be in a position to verify the evidence and confirm compliance in early 2023. Those participating in the negotiations caution that some details remain unresolved and the deal could still fall apart as lawmakers and staff rush to finalize the bill language, but interest from both sides is mounting. 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 Biden Administration announced on January 30 that the COVID-19 national public health emergency (PHE) will end on May 11, 2023. . If BBB had been enacted in December, states would have had three months to get ready. endstream endobj 507 0 obj <. V,wfBt3 [ho The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. But the Consolidated Appropriations Act, 2023 ensures that states continue to receive at least some additional federal Medicaid funding throughout 2023. So, there is some ambiguity as to when payments will be required to resume. By law, public health emergencies are declared in 90-day increments. Together, these findings suggest that individuals face barriers moving from Medicaid to other coverage programs, including S-CHIP. Written by Diane Archer. Churn can result in access barriers as well as additional administrative costs. Were hopeful that states will work to make the redeterminations and renewals process as transparent, accurate, and simple as possible. 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. the extra cost that states have incurred to cover the FFCRA-related enrollment growth. 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. 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. Simplifying those transitions to reduce the barriers people face could help ensure people who are no longer eligible for Medicaid do not become uninsured. The latest extension will expire on April 16, 2022. The resumption of eligibility redeterminations is no longer linked to end of public health emergency. 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. 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. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. 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. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision. Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. 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. Starting April 1, 2023, states can resume Medicaid disenrollments. Your email address will not be published. By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be . %%EOF 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. We didnt see that happen in 2020, thanks in large part to the availability of Medicaid and CHIP. 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). 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. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). Filling the need for trusted information on national health issues, Jennifer Tolbert and 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. That emergency is set to end in May. The public health emergency, first declared in January 2020 by the Trump administration, has been renewed every 90 days since the pandemic began. But we need to leverage every method to reach people on the program.. As a result, individuals who were enrolled in HUSKY Health may have their benefits extended . You can unsubscribe anytime you want. Heres what enrollees need to know. The PHE has been in place since January 27, 2020, and renewed throughout the pandemic. Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. 0 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. As COVID-19 becomes less of a threat and the federal government's public health emergency ends, states will restart yearly Medicaid and Children's Health Insurance Program (CHIP) eligibility reviews beginning April 1, 2023. 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. 0 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. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. 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. 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. 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. 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. Medical personnel prepare to prone a Covid-19 patient at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles. If you dont have access to an employer-sponsored plan and you are eligible for marketplace subsidies (most people are), the best course of action is to enroll in a marketplace plan as soon as you know that your Medicaid coverage will be terminated, in order to avoid or minimize a gap in coverage. 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. The recent CIB notes that CMS is expected to issue guidance to address how new reporting requirements (discussed below) may intersect with the requirements described in prior CMS guidance. The primary things to keep in mind: Your Medicaid coverage will continue if you continue to meet the eligibility guidelines and submit any necessary documentation as soon as its requested by the state. In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state PHE. States are also required to report on transitions to separate CHIP programs and to Marketplace or Basic Health Program coverage (Figure 10). 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. A nationwide public health emergency is in effect. The COVID-19 pandemic cast a spotlight on the importance of the various safety net systems that the U.S. has in place. Some of these waivers had previously expired, but ANA is still advocating to change the law and make them permanently part of the Medicare program. 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. And if this passes, Congress will essentially give states a 98-day notice.. Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. 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. The White House's Department of Health and Human Services (HHS) has extended the COVID-19 state of emergency. Total Medicaid/CHIP enrollment grew to 90.9 million in September 2022 . 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. 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. If the answer is yes, be sure you pay close attention to any requests for additional information from your states Medicaid office, as they may need that in order to keep your coverage in force. 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. 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. A PHE can be extended as many times as deemed necessary by the Secretary. That will resume in April 2023.). 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. Published: Feb 22, 2023. Democrats, in contrast, have been hesitant to tie the administrations hands as the virus continues to kill hundreds of people each day and a winter surge of several illnesses strains the countrys medical system. The public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. hbbd```b``>"IOjfo H80 f3Or e: ,`2DI[ v&,HK I+@ R The main waivers are: The end of the PHE will also have an effect on the Medicaid program. 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. center between 2018 and 2022 . It can be allowed to expire at the end of the 90-day period or terminated early if deemed appropriate. However, the Administrations superseding debt forgiveness program is still pending in the courts. 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. 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. As a result, in order for these waivers to continue, Congress must act and pass legislation making these waivers permanent. 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. President Biden says the emergency order will expire May 11. Section 319 of the Public Health Service Act gives the federal HHS Secretary the authority to make such a declaration when a severe disease . 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 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. . And the Consolidated Appropriations Act, 2023 provides for the additional federal Medicaid funding to gradually decrease throughout 2023, instead of ending abruptly at the end of the quarter in which the PHE ends. 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. 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 (PHE) ends. Oral arguments on the program were argued before the Supreme Court on February 28, and a decision is expected this Term. %PDF-1.7 % The move will maintain a range of health benefits . This additional match will be slowly wound down through 2023 and the federal match will be returned to what it had been prior to the PHE in January 2024. 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. 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 Consolidated Appropriations Act, 2023 decouples the Medicaid continuous enrollment provision from the PHE and terminates this provision on March 31, 2023. Yet Congress signaled change in the final days of 2022. What should you do if you currently have Medicaid coverage? 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. 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. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. Dont panic, but also dont delay, as your opportunity to enroll in new coverage will likely be time-limited. CMS is ending the requirement that the supervising clinician be immediately available at the end of the calendar year where the PHE ends. Congress has extended the telehealth flexibility through the end of 2024, but it is unclear if it will be extended further or made permanent. endstream endobj startxref Key Points. You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. 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. 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. 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. There is a relatively new special enrollment period that allows people with household income up to 150% of the poverty level to enroll in coverage year-round, for as long as the enhanced subsidies remain in place (so at least through the end of 2025, and possibly longer if Congress grants another extension). 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. endstream endobj startxref March 31, 2023 is the last day that states have to maintain the continuous coverage rules that have been in place since March 2020. Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. 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. A trusted independent health insurance guide since 1994. Without it, millions of additional Americans would have joined the ranks of the uninsured. (Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). 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). 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. 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. Get an email every time we post. Follow @meg_ammula on Twitter 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. The U.S. Department of Health and Human Services can extend the public health emergency in 90-day increments; it is currently set to end April 16. 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. 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 . 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. 3190 0 obj <>stream 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. 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). Low-income enrollees will able to enroll in ACA coverage during a special enrollment period. 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. 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. What does this mean for Medicaid? The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. 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