including education, public health, justice, environment, equity, and, . as proposed in the Build Back Better Act (BBB)? uyx'tE!~YV.v.wDO @:Z98-PtinB*[Elrcr[b8B9NX5IR'[UC.ok"zf3itMAiP((ISh. 4. This article has also been updated to note that the American Rescue Plans subsidy enhancements have been extended by the Inflation Reduction Act. 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. And yet, many states have indicated they need more not less lead time. The latest extension will expire on April 16, 2022. 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 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. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. Additionally, people with LEP and people with disabilities are more likely to encounter challenges due to language and other barriers accessing information in needed formats. By law, public health emergencies are declared in 90-day increments. Save my name, email, and website in this browser for the next time I comment. Your email address will not be published. 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. The PHE will probably be extended through the first half of 2022, and further extension is possible. This 152-day extension then ends on October 9. The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. endstream endobj startxref The PHE has been in place since January 27, 2020, and renewed throughout the pandemic. But the situation is evolvingas of February 3, 2023, 41 states had posted their full plan or a summary of their plan publicly. 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. But they could choose to do so, and could also choose to waive premiums for CHIP during that time. The Centers for Medicare & Medicaid Services (CMS) has released numerous guidance documents and tools designed to help states. The lower estimate accounts for factors, such as new people enrolling in the program as well as people disenrolling then re-enrolling in the program within the year, while the higher estimate reflects total disenrollment and does not account for churn or new enrollees. 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). The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. Medical personnel prepare to prone a Covid-19 patient at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles. For a person who is no longer Medicaid-eligible under normal rules, Medicaid coverage can end as early as April 1, 2023. You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. 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. On April 12, 2022, the Secretary of Health and Human Services (HHS), Xavier Becerra, announced the extension of the public health emergency (PHE) related to the Coronavirus Disease 2019 (COVID-19) pandemic. The lack of certainty is weighing on states and Medicaid stakeholders. | T p{YWY4,;U|p9 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). 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. for medical reasons related to the disaster or public health emergency, or who are otherwise absent from the state . If CMS determines a state is out of compliance with any applicable redetermination and reporting requirements, it can require the state to submit a corrective action plan and can require the state to suspend all or some terminations due to procedural reasons until the state takes appropriate corrective action. 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. 3168 0 obj <> endobj Many of these waivers and broad . Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). 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. Note: This brief was updated Feb. 22, 2023, to include more recent and additional data. 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. We are decoupling the Medicaid continuous eligibility policy from the Public Health Emergency. One of the benefits of this law is it allowed the State of Connecticut to extend Medicaid and CHIP ("HUSKY Health") coverage in response to the coronavirus pandemic. 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. 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). Fortunately, Medicaid was able to step in and provide health coverage when people lost their income. 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 . hb```+@(1IAcfK9[<6k`cts``NaPsg@uQVH(pGS 4)NtQlqV~T~(plUUv=@\8\:\4?LqB d However, we know Congress is considering delinking the FMAP bump and continuous enrollment and other maintenance of effort provisions from the PHE. Heres what enrollees need to know. 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. The Administration has stated that payments will resume either sixty days after the Supreme Court renders an opinion or June 30, whichever comes first. In the third quarter, it will drop to 2.5 percentage points, and in the fourth quarter of 2023, states will receive 1.5 percentage points in additional federal Medicaid funding. 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. Enrollees may experience short-term changes in income or circumstances that make them temporarily ineligible. People who can't access the website or who . Simplifying those transitions to reduce the barriers people face could help ensure people who are no longer eligible for Medicaid do not become uninsured. 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. 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. 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. 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. 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. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. Share on Facebook. 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. 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). Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). Published: Feb 22, 2023. hb```k- 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. Plus, if you funnel people into subsidized Obamacare plans, those are more expensive than Medicaid.. center between 2018 and 2022 . Sharing updates regarding the end of public health emergency declarations and extensions by way of the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. . Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. %PDF-1.7 % As of January 10, 2023, CMS had approved a total of 158 waivers for 41 states (Figure 6). 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. 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. 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 . %PDF-1.6 % About 4.2% were disenrolled and then re-enrolled within three months and 6.9% within six months. Democrats are on the record as being open to that, a Senate Republican aide told POLITICO. 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. instructed providers requesting an extension to specify, as part of their extension request, their plan for finishing their demonstrations of compliance by December 30, 2022. The White House's Department of Health and Human Services (HHS) has extended the COVID-19 state of emergency. Follow @meg_ammula on Twitter Moreover, research shows that when parents gained coverage under the Medicaid expansion, Medicaid participation among their eligible but unenrolled children also increased. 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. 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. Would love your thoughts, please comment. 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 PHE can be extended as many times as deemed necessary by the Secretary. However, when states do need to follow up with enrollees to obtain additional information to confirm ongoing eligibility, they can facilitate receipt of that information by allowing enrollees to submit information by mail, in person, over the phone, and online. 2716, the Consolidated . HHS projects that approximately 15 million people will lose eligibility for Medicaid once the normal eligibility redetermination process resumes. 01:02. Alternatively, some people who remain eligible may face barriers to maintaining coverage due to renewal processes and periodic eligibility checks. Share this: . The public health emergency, first declared in January 2020 by the Trump administration, has been renewed every 90 days since the pandemic began. Some have described this as the single largest enrollment event since the Affordable Care Act. On January 5, 2023, CMS released an Informational Bulletin that included timelines for states to submit a renewal redistribution plan (discussed above), system readiness plans and results, and baseline unwinding data based on when states plan to begin renewals. 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 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. Congress has extended the telehealth flexibility through the end of 2024, but it is unclear if it will be extended further or made permanent. Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. You can share your story about the impact of the Public Health Emergency HERE. 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. b1Y nact1X i"hi9!0 "@,f W1LL\vL1.ez,t_M8cp]4XfiFfm m2=sX1g`Vw? In the Calendar Year (CY) 2022 Home Health Prospective Payment System (PPS) final rule, CMS snuck . The move will maintain a range of health benefits . The impending termination of FFCRAs continuous coverage rules and return to business as usual for Medicaid can be a nerve-wracking prospect for some enrollees. HHS Secretary Xavier Becerra last renewed the COVID public health emergency on Jan. 11, 2023. Gov. V,wfBt3 [ho 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. Tate Reeves, after months of resistance, asks lawmakers to pass postpartum Medicaid extension by Bobby Harrison February 26, 2023 February 26, 2023. 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. HHS projects that nearly 8% of current Medicaid enrollees will lose their coverage despite continuing to be eligible once eligibility redeterminations resume. Heres what enrollees need to know. CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment. 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 non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). That emergency is set to end in May. 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. CMS guidance about the unwinding of the continuous enrollment provision stresses the importance of conducting outreach to enrollees to update contact information and provides strategies for partnering with other organizations to increase the likelihood that enrollee addresses and phone numbers are up to date. Herstate health exchange updatesare regularly cited by media who cover health reform and by other health insurance experts. Starting April 1, 2023, states can resume Medicaid disenrollments. As the end of the continuous enrollment provision approaches, states can collaborate with health plans and community organizations to conduct outreach to enrollees about the need to complete their annual renewal during the unwinding period. Dont panic: Coverage is almost certainly available. 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 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 This JAMA Forum discusses the potential ramifications after the COVID-19 public health emergency ends such as limiting telehealth, ending the continuous enrollment requirement in Medicaid, and decreasing regulatory flexibility that has allowed pharmacists to administer COVID-19 vaccines. Medicaid provides coverage to a vast. The main waivers are: The end of the PHE will also have an effect on the Medicaid program. However, if the guardrails are too flimsy or non-existent, states could see a surge in their uninsured populations right as government Covid funding runs dry, and individuals will have to depend on health plans to cover tests, vaccines and therapeutics for the virus. That will help us make the concrete plans necessary to make sure this happens in an orderly fashion.. The Administration's plan is to end the COVID-19 public health emergency (PHE) on May 11, 2023. 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. 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). Its clear their support and openness to it is contingent on reinvesting the savings back into Medicaid in a permanent way. 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. 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. CMS is referring to the return to normal eligibility redeterminations and disenrollments as a Medicaid and CHIP unwinding.. The ARP is still making premiums more affordable. A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994. 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. Most of the people who will become eligible for marketplace subsidies will be adults, as children are always much less likely than adults to qualify for marketplace subsidies. 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