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). 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. 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. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. The COVID SEP ended in most states. 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. Follow @meg_ammula on Twitter Founded in 2005, CCF is devoted to improving the health of Americas children and families, particularly those with low and moderate incomes. States are also required to report on transitions to separate CHIP programs and to Marketplace or Basic Health Program coverage (Figure 10). Especially after reports showing worsening health outcomes for mothers, investing these funds into extending Medicaid postpartum coverage is critical, said Rep. Robin Kelly (D-Ill.), who leads the health care task force for the Congressional Black Caucus. 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. Other than that, if you miss the special enrollment period for your particular coverage, youll have to wait until the next annual open enrollment period to sign up for coverage (employers set their own annual enrollment windows; Medicares general enrollment period is January March each year). 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). 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. Browse plans and costs with an easy, anonymous online tool. %%EOF The Biden administration extended the U.S. coronavirus public health emergency, now more than two years old, for another 90 days on Wednesday. Get an email every time we post. Read about your data and privacy. No one thought the public health emergency would stay forever. Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work. The Public Health Emergency and Extended Medicaid Coverage | Unwind Issues Impacting Miami-Dade County 11/16/2022 This webinar, sponsored by the South Florida Enrollment Coalition, discusses the continuous Medicaid coverage that has been part of the Public Health Emergency, the expected impact on Miami-Dade County residents currently on Medicaid, and what advocates should know in preparation . %PDF-1.6 % The Department of Health and Human Services (HHS) has extended the public health emergency eight times and is currently set to expire in April 2022. hbbd``b`$ = $: " Ms ]@B#F_ E+ The original date for resumption of payments is June 30 and that is still likely to continue, but if the Supreme Court issues a decision before the end of April that date would change. 2716, the Consolidated . 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). A trusted independent health insurance guide since 1994. 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. Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. 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. 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 Congressional Budget Office assumes the public health emergency for Covid will expire in July barring another extension by the Biden administration. 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. %PDF-1.7 % Without other action, states can start disenrolling people beginning May 1, 2022. But during the PHE, these individuals have not had their Medicaid coverage terminated. Find out how much financial help you may qualify for. Heres what enrollees need to know. 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. Lastly, states are required to maintain up to date contact information and attempt to contact enrollees prior to disenrollment when mail is returned. You can unsubscribe anytime you want. 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. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 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. That means that this will end on December 31 of this year. 4. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to 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). An Informational Bulletin (CIB) posted on January 5, 2023 included timelines for states to submit a renewal redistribution plan. 2022-2023 Medicaid Managed Care Rate Development Guide. 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 Biden administration on Friday extended the Covid-19 public health emergency for another three months. As of January 10, 2023, CMS had approved a total of 158 waivers for 41 states (Figure 6). Required fields are marked *. 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. Oral arguments on the program were argued before the Supreme Court on February 28, and a decision is expected this Term. 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. 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. 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 . forced a handful of successful Senate votes. 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. We didnt see that happen in 2020, thanks in large part to the availability of Medicaid and CHIP. 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. 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. (Prior to the pandemic, states had to recheck each enrollees eligibility at least once per year, and disenroll people who were no longer eligible. People using this window can, If youre eligible for Medicare, youll have. But the Consolidated Appropriations Act, 2023 ensures that states continue to receive at least some additional federal Medicaid funding throughout 2023. The move will maintain a range of health benefits . This article has also been updated to note that the American Rescue Plans subsidy enhancements have been extended by the Inflation Reduction Act. 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. For example, California and Rhode Island are planning to automatically enroll some people who lose Medicaid eligibility into a marketplace plan in their area (although they would still have the normal 60-day window to select a different plan or opt-out if they dont want marketplace 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. This 152-day extension then ends on October 9. The Administration has stated that payments will resume either sixty days after the Supreme Court renders an opinion or June 30, whichever comes first. 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. 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. Opens in a new window. 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. 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. 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. The ARP is still making premiums more affordable. 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. 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. 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. 1. 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. The latest extension will expire on 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. Can I use my Medicaid coverage in any state? How states approach the unwinding process will have implications for the ability of eligible individuals to retain coverage and those who are no longer eligible to transition to other coverage. Tate Reeves, after months of resistance, asks lawmakers to pass postpartum Medicaid extension by Bobby Harrison February 26, 2023 February 26, 2023. And if this passes, Congress will essentially give states a 98-day notice.. 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. This policy update will examine several of the health-related COVID-19 Federal Emergency Declarations and which flexibilities will end in May. 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. During the PHE, Medicaid enrollees automatically stayed enrolled in Medicaid and did not have to constantly keep proving eligibility. 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. 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. 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. However, we know Congress is considering delinking the FMAP bump and continuous enrollment and other maintenance of effort provisions from the PHE. Filling the need for trusted information on national health issues, Jennifer Tolbert and Gov. States can take action to minimize the number of people who become uninsured due to Medicaid eligibility redeterminations after the PHE. Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . 1. prepare for the eventual end of the COVID-19 public health emergency (PHE), including a State Health Official Letter, Promoting Continuity 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. 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. Save my name, email, and website in this browser for the next time I comment. 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. Key Points. In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state PHE. (Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). Any information we provide is limited to those plans we do offer in your area. %%EOF 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 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. 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. The White House's Department of Health and Human Services (HHS) has extended the COVID-19 state of emergency. The lack of certainty is weighing on states and Medicaid stakeholders. At that time, they will be required to conduct a full renewal based on current circumstances before disenrolling anyone. 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. Share this: . For the most up-to-date news and . The Center for Children & Families (CCF), part of the Health Policy Institute at the McCourt School of Public Policy at Georgetown University, is a nonpartisan policy and research center with a mission to expand and improve high-quality, affordable health coverage. 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. . That will help us make the concrete plans necessary to make sure this happens in an orderly fashion.. Some people who will lose Medicaid eligibility are now eligible for Medicare instead. as proposed in the Build Back Better Act (BBB)? We do not sell insurance products, but this form will connect you with partners of healthinsurance.org who do sell insurance products. In January 2020, the federal government enacted a national public health emergency that has since served as the "primary legal pillar of the U.S. pandemic response." 1 The emergency. In this brief, we project Medicaid enrollment for the population under age 65 and federal and state Medicaid spending for 2022 and . endstream endobj startxref But they could choose to do so, and could also choose to waive premiums for CHIP during that time. (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage. b1Y nact1X i"hi9!0 "@,f W1LL\vL1.ez,t_M8cp]4XfiFfm m2=sX1g`Vw? Also fueling Democrats shift: pressure from state health officials who have been lobbying Congress to give them a set date when their Covid posture will formally end after years of last-minute extensions from the White House. 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. The PHE has been in place since January 27, 2020, and renewed throughout the pandemic. 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. 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. 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. Congress has extended the telehealth flexibility through the end of 2024, but it is unclear if it will be extended further or made permanent. 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