A majority of states also indicated they were taking steps to update enrollee contact information and were planning to follow up with enrollees before terminating coverage. So where does this leave the continuous enrollment requirement? 0 Churn can result in access barriers as well as additional administrative costs. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. If you have questions or comments on this service, please contact us. The purpose of this bulletin is to inform providers that the federal public health emergency (PHE) was extended on January 14, 2022, and will now last until April 16, 2022. 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. As a result . 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. 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). To reduce the administrative burden on states, CMS announced the availability of temporary waivers through Section 1902(e)(14)(A) of the Social Security Act. 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. 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. 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. States can take action to minimize the number of people who become uninsured due to Medicaid eligibility redeterminations after the PHE. Importantly, these findings also show that large shares of enrollees (41% in the KFF analysis) reenroll in Medicaid after a period of time, and many after a period of uninsurance. We are decoupling the Medicaid continuous eligibility policy from the Public Health Emergency. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. 506 0 obj <> endobj Democrats want to make that harder, but if they put too many restrictions on states ability to do that, Im not sure how the math would work out. But during the PHE, these individuals have not had their Medicaid coverage terminated. That is now expected to happen in May 2023. 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. 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. But they could choose to do so, and could also choose to waive premiums for CHIP during that time. (PHE) ends. How many people will lose Medicaid coverage when the continuous coverage requirement ends? The main waivers are: The end of the PHE will also have an effect on the Medicaid program. 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. For a person who is no longer Medicaid-eligible under normal rules, Medicaid coverage can end as early as April 1, 2023. No one thought the public health emergency would stay forever. But the overall pace of Medicaid eligibility redeterminations and disenrollments will vary considerably from one state to another. 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. Can I use my Medicaid coverage in any state? Tate Reeves, after months of resistance, asks lawmakers to pass postpartum Medicaid extension by Bobby Harrison February 26, 2023 February 26, 2023. Read about your data and privacy. Were hopeful that states will work to make the redeterminations and renewals process as transparent, accurate, and simple as possible. 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. And all states accepted the additional federal Medicaid funding. Together, these findings suggest that individuals face barriers moving from Medicaid to other coverage programs, including S-CHIP. If youre currently enrolled in Medicaid, its a good idea to familiarize yourself with your states eligibility rules, and figure out whether youd be eligible if you were to apply today, with your current circumstances and income. How the COVID relief law will rescue marketplace plan buyers, If you have access to an employer-sponsored health plan, your loss of Medicaid coverage will trigger a special enrollment period that will allow you to enroll in the employer-sponsored plan. hbbd``b`$ = $: " Ms ]@B#F_ E+ including education, public health, justice, environment, equity, and, . Medicaid enrollees should pay close attention to redetermination notices that they may receive once normal eligibility redeterminations resume. 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. A survey of health centers conducted in late 2021 found that nearly 50% of responding health centers reported they have or plan to reach out to their Medicaid patients with reminders to renew their coverage and to schedule appointments to assist them with renewing coverage. An Informational Bulletin (CIB) posted on January 5, 2023 included timelines for states to submit a renewal redistribution plan. 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. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. 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. 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 541 0 obj <>stream 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. Please contact Medicare.gov or 1800 MEDICARE to get information on all of your options. 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. 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. 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). 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. 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. HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. Many of these waivers and broad . Lastly, states are required to maintain up to date contact information and attempt to contact enrollees prior to disenrollment when mail is returned. Brief What Will Happen to Medicaid Enrollees' Health Coverage after the Public Health Emergency . . 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. People who can't access the website or who . We do not sell insurance products, but this form will connect you with partners of healthinsurance.org who do sell insurance products. 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. 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. HHS projects that nearly 8% of current Medicaid enrollees will lose their coverage despite continuing to be eligible once eligibility redeterminations resume. 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). Because of specific Congressional action many of the telehealth flexibilities authorized under the PHE will continue through the end of 2024. In the second quarter, that will drop to 5 percentage points. 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. 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. By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. 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. Or maybe your circumstances have changed perhaps your income is the same but you have fewer people in your household and your income now puts you at a higher percentage of the poverty level. The public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. 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. These plans must describe how the state will prioritize renewals, how long the state plans to take to complete the renewals as well as the processes and strategies the state is considering or has adopted to reduce inappropriate coverage loss during the unwinding period. 3. Medicaid provides coverage to a vast. Some people who will lose Medicaid eligibility are now eligible for Medicare instead. 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. The GOP-led Senate passed the proposal in the 2022 session, but it was killed in the House. Healthcare Dive reports that the majority of people with Medicaid do not know that their coverage could end when the public health emergency ends. 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. 4. March 31, 2023 is the last day that states have to maintain the continuous coverage rules that have been in place since March 2020. This article has also been updated to note that the American Rescue Plans subsidy enhancements have been extended by the Inflation Reduction Act. 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. In some states, it will be the most significant enrollment action in the 50+ year history of Medicaid. A trusted independent health insurance guide since 1994. Ensuring accessibility of information, forms, and assistance will be key for preventing coverage losses and gaps among these individuals. Plus, if you funnel people into subsidized Obamacare plans, those are more expensive than Medicaid.. And if this passes, Congress will essentially give states a 98-day notice.. Nearly every state has been conducting some type of outreach campaign around this, asking Medicaid enrollees to be sure that the state has their current contact information on file. This 152-day extension then ends on October 9. 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. Its clear their support and openness to it is contingent on reinvesting the savings back into Medicaid in a permanent way. 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 . The Biden administration on Friday extended the Covid-19 public health emergency for another three months. 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. This would have incentivized some states to act as quickly as possible to disenroll people from Medicaid. | Jae C. Hong/AP Photo. 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. Some states suspended renewals as they implemented the continuous enrollment provision and made other COVID-related adjustments to operations. Low-income enrollees will able to enroll in ACA coverage during a special enrollment period. The lack of certainty is weighing on states and Medicaid stakeholders. Republicans have long called for ending the public health emergency for Covid-19 and have forced a handful of successful Senate votes that were then blocked in the House. 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. Home > Blog > Medicaid eligibility redeterminations will resume in 2023. During the PHE, Medicaid agencies have not disenrolled most members, even if someone's eligibility changed . The Administration's plan is to end the COVID-19 public health emergency (PHE) on May 11, 2023. Starting April 1, 2023, states can resume Medicaid disenrollments. 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. Dig Deeper Medicaid Spending on. Lawmakers have struck an agreement to move the end of its Medicaid rules. 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. Both . Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision. The latest extension will expire on April 16, 2022. Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . 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. Without other action, states can start disenrolling people beginning May 1, 2022. CMS notes in recent guidance that states can increase the share of ex parte renewals they complete without having to follow up with the enrollee by expanding the data sources they use to verify ongoing eligibility. The public health emergency, first declared in January 2020 by the Trump administration, has been renewed every 90 days since the pandemic began. 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). 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. Some people who will lose Medicaid eligibility are now eligible for Medicare instead. These projected coverage losses are consistent with, though a bit lower than, estimates from the Department of Health and Human Services (HHS) suggesting that as many as 15 million people will be disenrolled, including 6.8 million who will likely still be eligible. For system readiness reporting, states are required to demonstrate that their eligibility systems for processing renewals are functioning correctly, particularly since states have not been conducting normal renewals while the continuous enrollment provision has been in effect. The White House's Department of Health and Human Services (HHS) has extended the COVID-19 state of emergency. 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. So the Consolidated Appropriations Act, 2023 does require states to use the U.S. Post Offices change of address database and/or state Department of Health and Human Services data to ensure that the state has updated contact information for people whose coverage eligibility is being redetermined. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. 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. What does this mean for Medicaid? 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. Find out how much financial help you may qualify for. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. 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?. 1. prepare for the eventual end of the COVID-19 public health emergency (PHE), including a State Health Official Letter, Promoting Continuity Now, Democrats are prepared to join them four people close to the negotiations tell POLITICO. 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. And since coverage cannot be backdated, its essential to ensure that youre covered before any medical needs arise. The powers activated by the emergency. (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment. 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). 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. 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. 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). Many states have continued to send out these renewal notifications and information requests throughout the pandemic (nearly all states have been conducting automatic (ex parte) renewals when possible, and more than half the states have also been sending renewal forms to enrollees). Medicaid enrollment increased by over 17 million from February 2020 to May 2022. Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. But if the answer is no, be prepared for a coverage termination notice at some point after the end of March 2023. But the continued enrollment growth in Medicaid is primarily due to the fact that the Families First Coronavirus Response Act (FFCRA), enacted in March 2020, has been providing states with additional federal funding for their Medicaid programs, as long as they dont disenroll people from Medicaid during the COVID public health emergency (PHE) period. 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. 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 a result, in order for these waivers to continue, Congress must act and pass legislation making these waivers permanent. 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. In a May 2022 letter to governors, HHS noted We strongly encourage your state to use the entire 12-month unwinding period to put in place processes that will prevent terminations of coverage for individuals still eligible for Medicaid as your state works through its pending eligibility actions.. 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). So, there is some ambiguity as to when payments will be required to resume. endstream endobj 507 0 obj <. Section 319 of the Public Health Service Act gives the federal HHS Secretary the authority to make such a declaration when a severe disease . In the Calendar Year (CY) 2022 Home Health Prospective Payment System (PPS) final rule, CMS snuck . HHS Secretary Xavier Becerra last renewed the COVID public health emergency on Jan. 11, 2023. 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