HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. endstream endobj 507 0 obj <. If the answer is yes, be sure you pay close attention to any requests for additional information from your states Medicaid office, as they may need that in order to keep your coverage in force. Of the 42 states processing ex parte renewals for MAGI groups (people whose eligibility is based on modified adjusted gross income), only 11 states report completing 50% or more of renewals using ex parte processes. 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. As a result, individuals who were enrolled in HUSKY Health may have their benefits extended . The main waivers are: The end of the PHE will also have an effect on the Medicaid program. 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. How many people will lose Medicaid coverage when the continuous coverage requirement ends? 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). 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. That means that this will end on December 31 of this year. 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. The new rules give states a clear time frame: They can begin to initiate the renewal/redetermination process as early as February 1, 2023 (states can start this in February, March, or April), and disenrollments can be effective as early as April 1, 2023 if adequate notice is given to the enrollee. Findings This cohort study of 4869 Latina patients with gestational (n = 2907) or preexisting diabetes (n . States that fail to comply with these reporting requirements face a reduction in federal medical assistance percentage (FMAP) of up to one percentage point for the quarter in which the requirements are not met. MOUNT VERNON As the COVID-19 public health emergency nears its end, eligible families and individuals risk losing Medicaid coverage and SNAP food stamp benefits through a process often called "unwinding." "The changes that are upon us do not necessarily affect everybody, but a lot of people accustomed to getting Medicaid or SNAP, if . Please contact Medicare.gov or 1800 MEDICARE to get information on all of your options. 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. 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. 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. The Congressional Budget Office assumes the public health emergency for Covid will expire in July barring another extension by the Biden administration. 0 We didnt see that happen in 2020, thanks in large part to the availability of Medicaid and CHIP. The latest extension will expire on April 16, 2022. 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. Medicaid enrollees should pay close attention to redetermination notices that they may receive once normal eligibility redeterminations resume. And if this passes, Congress will essentially give states a 98-day notice.. 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. Churn can result in access barriers as well as additional administrative costs. (PHE) ends. 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. That same analysis revealed that a majority of states provide general information about reasonable modifications and teletypewriter (TTY) numbers on or within one click of their homepage or online application landing page (Figure 8), but fewer states provide information on how to access applications in large print or Braille or how to access American Sign Language interpreters. Low-income enrollees will able to enroll in ACA coverage during a special enrollment period. But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage. 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. 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. US Department of Health and Human Services Secretary Xavier Becerra . Click Check Out Now. %%EOF 0 What are your options if youre no longer eligible for Medicaid? But they could choose to do so, and could also choose to waive premiums for CHIP during that time. With respect to Medicare: We do not offer every plan available in your area. Nursing school is expensive and as a result roughly of nursing students take out federal student loans to help pay for school. The move will maintain a range of health benefits . Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. hbbd``b`$ = $: " Ms ]@B#F_ E+ The Biden administration on Friday extended the Covid-19 public health emergency for another three months. 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. Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270, www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff. Prescribed Pediatric Extended Care services by 15% effective October 1, 2022 through the end of the public health emergency. endstream endobj startxref Share on Facebook. [Editors Note: Read the latest on the public health emergency Medicaid continuous coverage protectionhere.]. 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. It also provides states more time to prepare for new rules that will put millions in jeopardy of losing their health insurance, something state Medicaid directors have been demanding from legislators. 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. You can unsubscribe anytime you want. 4. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. People using this window can, If youre eligible for Medicare, youll have. What if your income has increased to a level thats no longer Medicaid-eligible? Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. hbbd```b``>"IOjfo H80 f3Or e: ,`2DI[ v&,HK I+@ R 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). 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). We are decoupling the Medicaid continuous eligibility policy from the Public Health Emergency. Your email address will not be published. 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 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 . But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. 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. 3190 0 obj <>stream And all states accepted the additional federal Medicaid funding. 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 requires states to develop operational plans for how they will approach the unwinding process. 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. Meghana Ammula 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 . 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 By law, public health emergencies are declared in 90-day increments. But this will not happen all at once, as each state will have its own approach to the resumption of eligibility redeterminations. HHS projects that approximately 15 million people will lose eligibility for Medicaid once the normal eligibility redetermination process resumes. The Biden administration extended the U.S. coronavirus public health emergency, now more than two years old, for another 90 days on Wednesday. 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 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. Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. 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). Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during 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. Because of specific Congressional action many of the telehealth flexibilities authorized under the PHE will continue through the end of 2024. Starting April 1, 2023, states can resume Medicaid disenrollments. 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. Importantly, the legislation requires these reports be made publicly available. 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. Find out how much financial help you may qualify for. The Consolidated Appropriations Act, 2023 decouples the Medicaid continuous enrollment provision from the PHE and terminates this provision on March 31, 2023. (Note that there are several terms that are used interchangeably: Eligibility redetermination, renewal, case review, recertification, and redetermination all mean the same thing, and refer to the process by which the state determines whether a Medicaid enrollee is eligible to continue to receive Medicaid.). 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. 3. Fortunately, Medicaid was able to step in and provide health coverage when people lost their income. But because Democrats are squeamish about this, theyre going to use it to drive a hard bargain. The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. This 152-day extension then ends on October 9. b1Y nact1X i"hi9!0 "@,f W1LL\vL1.ez,t_M8cp]4XfiFfm m2=sX1g`Vw? 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. Medical personnel prepare to prone a Covid-19 patient at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. For the most up-to-date news and . The lack of certainty is weighing on states and Medicaid stakeholders. Democrats, in contrast, have been hesitant to tie the administrations hands as the virus continues to kill hundreds of people each day and a winter surge of several illnesses strains the countrys medical system. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. The state has to make a good-faith effort to find the person first. Healthcare Dive reports that the majority of people with Medicaid do not know that their coverage could end when the public health emergency ends. The public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. 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). Under the prior rules, that would have meant that Medicaid eligibility redeterminations (and terminations) could have resumed as of June 2023. . 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. (Note that the Biden administration has implemented a fix for the family glitch, making some employees family members newly eligible for marketplace subsidies in 2023 even with an offer of employer-sponsored coverage.). | Jae C. Hong/AP Photo. President Biden says the emergency order will expire May 11. A trusted independent health insurance guide since 1994. 3168 0 obj <> endobj The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. Some states suspended renewals as they implemented the continuous enrollment provision and made other COVID-related adjustments to operations. 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. Some people who will lose Medicaid eligibility are now eligible for Medicare instead. By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. (Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). Simplifying those transitions to reduce the barriers people face could help ensure people who are no longer eligible for Medicaid do not become uninsured. 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. 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. HHS Secretary Xavier Becerra last renewed the COVID public health emergency on Jan. 11, 2023. 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. 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. Under normal circumstances, they would have lost their Medicaid eligibility upon turning 65, as the Medicaid eligibility rules are much different (and include asset tests) for people 65 and older. Doing so would decrease federal spending on Medicaid and allow states to remove ineligible people from the program, saving the government tens of billions of dollars. 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). 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). If you have questions or comments on this service, please contact us. Primarily due to the continuous enrollment provision, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped. Were providing certainty to states and giving them a gradual stream of funding and guardrail requirements that protect people. Medicaid provides coverage to a vast. Any information we provide is limited to those plans we do offer in your area. Home > Blog > Medicaid eligibility redeterminations will resume in 2023. Congressional negotiators are set to unveil the text of the 2023 omnibus spending bill on Monday. So where does this leave the continuous enrollment requirement? Together, these findings suggest that individuals face barriers moving from Medicaid to other coverage programs, including S-CHIP. We are not ending the PHE, said a Capitol Hill source close to the negotiations, granted anonymity to discuss a deal that is still in flux. October 17, 2022. 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. 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. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision. Heres what enrollees need to know. This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made, and summarizes the flexibilities triggered by each in the following. 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. 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. 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. CMS is ending the requirement that the supervising clinician be immediately available at the end of the calendar year where the PHE ends. Much of Medicare is in statute, and as a result the Administration has limited authority to expand telehealth absent Congressional action. 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. A nationwide public health emergency is in effect. 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. On March 18, 2020, the Families First Coronavirus Response Act was signed into law. Brief What Will Happen to Medicaid Enrollees' Health Coverage after the Public Health Emergency . 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. All orders will be shipped via First Class Package Service. 1. Published: Feb 22, 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. That emergency is set to end in May. uyx'tE!~YV.v.wDO @:Z98-PtinB*[Elrcr[b8B9NX5IR'[UC.ok"zf3itMAiP((ISh. 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. 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. Yet Congress signaled change in the final days of 2022. 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. 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). 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. 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). That is now expected to happen in May 2023. Alternatively, some people who remain eligible may face barriers to maintaining coverage due to renewal processes and periodic eligibility checks. In this brief, we project Medicaid enrollment for the population under age 65 and federal and state Medicaid spending for 2022 and . 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 GOP-led Senate passed the proposal in the 2022 session, but it was killed in the House. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be . 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. 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). The PHE will probably be extended through the first half of 2022, and further extension is possible. As of January 10, 2023, CMS had approved a total of 158 waivers for 41 states (Figure 6). The powers activated by the emergency. . 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. 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 Biden administration announced its intention to end the federal public health emergency on May 11, 2023. 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. 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. 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