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. 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. 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. Find out how much financial help you may qualify for. For the first quarter of 2023, states will continue to get the 6.2 percentage point boost that theyve been receiving throughout the pandemic. The law also prohibits states from disenrolling a person simply based on undelivered mail. 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. The latest extension will expire on April 16, 2022. 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 The move will maintain a range of health benefits . Primarily due to the continuous enrollment provision, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped. Some people who will lose Medicaid eligibility are now eligible for Medicare instead. Its clear their support and openness to it is contingent on reinvesting the savings back into Medicaid in a permanent way. A PHE can be extended as many times as deemed necessary by the Secretary. Click Check Out Now. HHS projects that approximately 15 million people will lose eligibility for Medicaid once the normal eligibility redetermination process resumes. Written by Diane Archer. Without other action, states can start disenrolling people beginning May 1, 2022. The PA MEDI Helpline is available at 1-800-783-7067 from 8 a.m. to 5 p.m. Monday-Friday. 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. 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. All orders will be shipped via First Class Package Service. Medicaid enrollees should pay close attention to redetermination notices that they may receive once normal eligibility redeterminations resume. | Jae C. Hong/AP Photo. The Biden administration on Friday extended the Covid-19 public health emergency for another three months. 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. However, there will also be current enrollees who are determined to be no longer be eligible for Medicaid, but who may be eligible for ACA marketplace or other coverage. We didnt see that happen in 2020, thanks in large part to the availability of Medicaid and CHIP. Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. 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 White House's Department of Health and Human Services (HHS) has extended the COVID-19 state of emergency. Dig Deeper Medicaid Spending on. These enhanced reporting metrics require states to report the total number of individuals renewed and those renewed on an ex parte basis, break out Medicaid terminations for childrens coverage and pregnancy-related coverage, report the number of individuals whose coverage was terminated for procedural reasons, including breakouts for childrens coverage and pregnancy-related coverage, and report total call center volume, average wait time, and average abandonment rate. 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. 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. Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. On March 18, 2020, the Families First Coronavirus Response Act was signed into law. 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. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. Starting April 1, 2023, states can resume Medicaid disenrollments. But that was an uncertain and ever-changing date, as the PHE has continued to be extended. 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. Congressional negotiators are set to unveil the text of the 2023 omnibus spending bill on Monday. 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. Founded in 2005, CCF is devoted to improving the health of Americas children and families, particularly those with low and moderate incomes. You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. Twenty-eight states indicated they had settled on plan for prioritizing renewals while 41 said they planning to take 12 months to complete all renewals (the remaining 10 states said they planned to take less than 12 months to complete renewals or they had not yet decided on a timeframe). This should include an email address and cell phone number if you have them, as states are increasingly using email and text messages, as well as regular mail, to contact enrollees. [Editors Note: Read the latest on the public health emergency Medicaid continuous coverage protectionhere.]. endstream endobj startxref Heres what enrollees need to know. Friday, February 24, 2023. 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). 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 The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. 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. The main waivers are: The end of the PHE will also have an effect on the Medicaid program. during which you can transition to Medicare without any late enrollment penalties. The question is: Can they get enough wins to take the political sting off allowing states to kick people off the rolls?. Churn can result in access barriers as well as additional administrative costs. There are also monthly reporting rules included in the law, designed to ensure transparency and accountability throughout the unwinding of the FFCRAs continuous coverage requirements. Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. The Biden administration has extended the Covid-19 public health emergency as a highly transmissible omicron subvariant stokes concern that the nation may face another wave of. This would have incentivized some states to act as quickly as possible to disenroll people from Medicaid. That means that this will end on December 31 of this year. Medicaid enrollment increased by over 17 million from February 2020 to May 2022. 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. The recently enacted Consolidated Appropriations Act includes additional reporting requirements for states and imposes penalties in the form of reduced federal matching payments for states that do not comply. But we need to leverage every method to reach people on the program.. . Dont panic, but also dont delay, as your opportunity to enroll in new coverage will likely be time-limited. 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. No one thought the public health emergency would stay forever. 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. Follow @meg_ammula on Twitter That will resume in April 2023.). 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. In this brief, we project Medicaid enrollment for the population under age 65 and federal and state Medicaid spending for 2022 and . Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . If the PHE ends in April 2023, the FFCRAs rules would have resulted in the additional federal Medicaid funding (6.2 percentage points added to a states regular federal Medicaid funding) ending altogether at the end of June 2023. The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. (Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). 3. However, waivers that allowed advanced practice registered nurses (APRNs) to practice at the top of their license will expire on October 9 absent further Congressional action. Oral arguments on the program were argued before the Supreme Court on February 28, and a decision is expected this Term. 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. 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. Lawmakers have struck an agreement to move the end of its Medicaid rules. 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). 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. Republicans pushing for the deal have also been reminding Democrats that their original Build Back Better legislative package which ultimately became the Inflation Reduction Act and passed this year after being significantly whittled down included a wind-down of the public health emergency as a pay-for. The Biden administration extended the U.S. coronavirus public health emergency, now more than two years old, for another 90 days on Wednesday. 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. including education, public health, justice, environment, equity, and, . Low-income enrollees will able to enroll in ACA coverage during a special enrollment period. For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. Heres what enrollees need to know. Louise Norrisis anindividual health insurancebroker who has been writing about health insurance and health reform since 2006. 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. 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). 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). Many people who enrolled in Medicaid since early 2020 have never experienced the regular eligibility redeterminations and renewal processes that have long been a part of Medicaid, and those will resume in April 2023 (some enrollees wont receive a renewal notification for several months after that, depending on the approach that their state uses). And all states accepted the additional federal Medicaid funding. 7.8 million enrollees by March 2023. For those individuals, there will generally be two primary options for post-Medicaid coverage: An employer-sponsored plan, or a plan obtained in the health insurance exchange/marketplace. (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). for medical reasons related to the disaster or public health emergency, or who are otherwise absent from the state . The most recent draft of the BBB would have begun to phase out the enhanced FMAP in the second and third quarters of the year (April September 2022) and, if it becomes law as written, states would be allowed to restart renewals as of April 1st. 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. An analysis of state Medicaid websites found that while a majority of states translate their online application landing page or PDF application into other languages, most only provide Spanish translations (Figure 7). By law, public health emergencies are declared in 90-day increments. The Centers for Medicare & Medicaid Services (CMS) implemented several interim final rules during the PHE. 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. Read about your data and privacy. About 4.2% were disenrolled and then re-enrolled within three months and 6.9% within six months. 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. 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. 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. 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. However, the Administrations superseding debt forgiveness program is still pending in the courts. If BBB had been enacted in December, states would have had three months to get ready. And those renewals must be completed no later than May 31, 2024, This 12-month period to initiate renewals and 14-month period to complete them had already been the case under previous guidance that the Biden administration had issued. forced a handful of successful Senate votes. If your state notifies you that youre no longer eligible for Medicaid and you believe that you are still eligible, you can appeal the states decision. So, there is some ambiguity as to when payments will be required to resume. 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). 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. 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. Lastly, states are required to maintain up to date contact information and attempt to contact enrollees prior to disenrollment when mail is returned. Verify that your information is correct and select Place My Order. That will help us make the concrete plans necessary to make sure this happens in an orderly fashion.. But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. %%EOF A trusted independent health insurance guide since 1994. Some have described this as the single largest enrollment event since the Affordable Care Act. 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. %%EOF The Biden administration announced its intention to end the federal public health emergency on May 11, 2023. 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. Were hopeful that states will work to make the redeterminations and renewals process as transparent, accurate, and simple as possible. 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. Your email address will not be published. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. 2716, the Consolidated . 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. With Republicans set to take control of House in January, Democrats see the move as the best and possibly last chance to fund some of their top health priorities, including policies that address the countrys worsening rates of maternal mortality that were left out of other packages passed this year. And yet, many states have indicated they need more not less lead time. The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. The Centers for Medicare & Medicaid Services (CMS) has released numerous guidance documents and tools designed to help states. 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 GOP-led Senate passed the proposal in the 2022 session, but it was killed in the House. 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. What do these three possible scenarios mean for Medicaid if Congress does not take additional action as proposed in the Build Back Better Act (BBB)? 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. Would love your thoughts, please comment. Get an email every time we post. 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. 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. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. States have already begun rechecking people with Medicaid for eligibility, Millions of them are at high risk of losing their Medicaid coverage as soon as April 1. 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 . as proposed in the Build Back Better Act (BBB)? Helping millions of Americans since 1994. During the PHE, Medicaid agencies have not disenrolled most members, even if someone's eligibility changed . 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. The COVID SEP ended in most states. 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. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be significant. According to an Urban Institute analysis, about a third of the people losing Medicaid will be eligible for premium tax credits (subsidies) in the marketplace, while about two-thirds will be eligible for employer-sponsored coverage that meets the ACAs definition of affordable. In some states, it will be the most significant enrollment action in the 50+ year history of Medicaid. (Prior to the pandemic, states had to recheck each enrollees eligibility at least once per year, and disenroll people who were no longer eligible. Medicaid eligibility redeterminations will resume in 2023. Section 319 of the Public Health Service Act gives the federal HHS Secretary the authority to make such a declaration when a severe disease . 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. Prescribed Pediatric Extended Care services by 15% effective October 1, 2022 through the end of the public health emergency. 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. Meghana Ammula Alternatively, some people who remain eligible may face barriers to maintaining coverage due to renewal processes and periodic eligibility checks. The overriding thing state Medicaid agencies want is certainty about what is coming, Jack Rollins, the director of federal policy for the National Association of Medicaid Directors, told POLITICO. 0 And some states that also offer additional state-funded subsidies allow people with higher incomes to enroll year-round. In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state 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. You can share your story about the impact of the Public Health Emergency HERE. CMS guidance also outlines specific steps states can take, including ensuring accessibility of forms and notices for people with LEP and people with disabilities and reviewing communications strategies to ensure accessibility of information. People using this window can, If youre eligible for Medicare, youll have. Please contact Medicare.gov or 1800 MEDICARE to get information on all of your options. As a result, individuals who were enrolled in HUSKY Health may have their benefits extended . 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. A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994. States can take action to minimize the number of people who become uninsured due to Medicaid eligibility redeterminations after 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. 541 0 obj <>stream CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment. Some people who will lose Medicaid eligibility are now eligible for Medicare instead. The resumption of eligibility redeterminations is no longer linked to end of public health emergency. 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. 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 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. Please provide your zip code to see plans in your area. Dont panic: Coverage is almost certainly available. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. But because Democrats are squeamish about this, theyre going to use it to drive a hard bargain. As states prepare to complete redeterminations for all Medicaid enrollees once the continuous enrollment provision ends, many may face significant operational challenges related to staffing shortages and outdated systems. The impending termination of FFCRAs continuous coverage rules and return to business as usual for Medicaid can be a nerve-wracking prospect for some enrollees. 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. 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. 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). This provision requires states to provide continuous coverage for Medicaid enrollees until the end of the month in which the public health emergency (PHE) ends in order to receive enhanced federal funding. Further, states must also comply with federal rules about conducting renewals. , or who are otherwise absent from the state large part to the continuous enrollment provision, Medicaid has! Of Medicaid of CMS guidance documents and tools designed to help states trusted independent insurance... Democrats are squeamish about this, theyre going to use it to drive a hard.. Result in access barriers as well discuss in a moment, the Administrations superseding forgiveness! 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