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. Helping millions of Americans since 1994. 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. center between 2018 and 2022 . So where does this leave the continuous enrollment requirement? 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. This is true regardless of whether youll qualify for the new low-income special enrollment period, since youll have a normal loss-of-coverage special enrollment period when your Medicaid ends, and you can take advantage of it right away. endstream endobj startxref 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. The latest extension will expire on April 16, 2022. 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). 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. %PDF-1.6 % 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. 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. First, the maintenance of effort provisions in the Families First Coronavirus Response Act remain in effect until January 31, 2022 (the end of the month after the PHE ends). 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. But if the answer is no, be prepared for a coverage termination notice at some point after the end of March 2023. It can be allowed to expire at the end of the 90-day period or terminated early if deemed appropriate. As states return to routine operations when the continuous enrollment provision ends, there are opportunities to promote continuity of coverage among enrollees who remain eligible by increasing the share of renewals completed using ex parte processes and taking other steps to streamline renewal processes (which will also tend to increase enrollment and spending). Together, these findings suggest that individuals face barriers moving from Medicaid to other coverage programs, including S-CHIP. Plus, if you funnel people into subsidized Obamacare plans, those are more expensive than Medicaid.. 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. 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. Browse plans and costs with an easy, anonymous online tool. Founded in 2005, CCF is devoted to improving the health of Americas children and families, particularly those with low and moderate incomes. 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. The PHE will probably be extended through the first half of 2022, and further extension is possible. 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. 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. The ARP is still making premiums more affordable. 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. Low-income enrollees will able to enroll in ACA coverage during a special enrollment period. But because Democrats are squeamish about this, theyre going to use it to drive a hard bargain. The PHE is expected to continue until mid-May 2023. A MACPAC analysis examined coverage transitions for adults and children who were disenrolled from Medicaid or separate CHIP (S-CHIP) and found that very few adults or children transitioned to federal Marketplace coverage, only 21% of children transitioned from Medicaid to S-CHIP, while 47% of children transitioned from S-CHIP to Medicaid (Figure 11). 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. 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. 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. She has written dozens of opinions and educational pieces about theAffordable Care Actfor healthinsurance.org. But enrollment has trended upward throughout the pandemic, without the normal disenrollments that previously stemmed from the regular Medicaid eligibility redetermination process. 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. What are your options if youre no longer eligible for Medicaid? CMS is referring to the return to normal eligibility redeterminations and disenrollments as a Medicaid and CHIP unwinding.. 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 extra cost that states have incurred to cover the FFCRA-related enrollment growth. 2022 Congressional Spending Bill Included Several ANA-Supported Nursing Provisions to Cap off the Year, The End of the Public Health Emergency and What this Means for Nurses, APRNs Can Provide Quality and Access to Care and Congress Needs to Let Them, Introducing the Safe Staffing for Nurse and Patient Safety Act, House Tax Bills Impacts on Nurses and Consumers, House Tax Bills Impacts on Nurses and Consumers Capitol Beat, Better Late, Than Never House and Senate Make Moves on CHIP. 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. Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California. Much of Medicare is in statute, and as a result the Administration has limited authority to expand telehealth absent Congressional action. Please provide your zip code to see plans in your area. A proposed rule, released on September 7, 2022, seeks to streamline enrollment and renewal processes in the future by applying the same rules for MAGI and non-MAGI populations, including limiting renewals to once per year, prohibiting in-person interviews and requiring the use of prepopulated renewal forms. HHS projects that nearly 8% of current Medicaid enrollees will lose their coverage despite continuing to be eligible once eligibility redeterminations resume. 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. Preparing for the End of COVID-19: Return to Regular Renewals . 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. as proposed in the Build Back Better Act (BBB)? The PA MEDI Helpline is available at 1-800-783-7067 from 8 a.m. to 5 p.m. Monday-Friday. This would have incentivized some states to act as quickly as possible to disenroll people from Medicaid. 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. 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. HHS says it plans to extend Covid-19 public health emergency - POLITICO Health Care HHS says it plans to extend Covid-19 public health emergency An extension would ensure expanded. 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. 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. Lawmakers have struck an agreement to move the end of its Medicaid rules. NOTE: States may not elect a period longer than the Presidential or Secretarial emergency declaration . Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . 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. Heres what enrollees need to know. Democrats are on the record as being open to that, a Senate Republican aide told POLITICO. 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. Can I use my Medicaid coverage in any state? %PDF-1.7 % 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. People using this window can, If youre eligible for Medicare, youll have. 7.8 million enrollees by March 2023. Medicaid enrollment increased by over 17 million from February 2020 to May 2022. 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. 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. 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 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. Your email address will not be published. EDITORS NOTE: This article was first posted in March 2022 but has been updated to reflect the passage of the Consolidated Appropriations Act, 2023 (the omnibus spending bill). Share on Facebook. 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. 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). The Congressional Budget Office assumes the public health emergency for Covid will expire in July barring another extension by the Biden administration. Get an email every time we post. 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. US Department of Health and Human Services Secretary Xavier Becerra . Dig Deeper Medicaid Spending on. 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. 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