(Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). hb```k- 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. Without other action, states can start disenrolling people beginning May 1, 2022. PA MEDI Counselors are specially trained to answer your questions and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance. But during the PHE, these individuals have not had their Medicaid coverage terminated. 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. Yet Congress signaled change in the final days of 2022. the extra cost that states have incurred to cover the FFCRA-related enrollment growth. Under the ACA, states must seek to complete administrative (or ex parte) renewals by verifying ongoing eligibility through available data sources, such as state wage databases, before sending a renewal form or requesting documentation from an enrollee. That is now expected to happen in May 2023. What are your coverage options if youre disenrolled from Medicaid? But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. If you have questions or comments on this service, please contact us. So the Consolidated Appropriations Act, 2023 does require states to use the U.S. Post Offices change of address database and/or state Department of Health and Human Services data to ensure that the state has updated contact information for people whose coverage eligibility is being redetermined. 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. 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. 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. 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). 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. 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. An Informational Bulletin (CIB) posted on January 5, 2023 included timelines for states to submit a renewal redistribution plan. Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. 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. But even if youre eligible for this ongoing special enrollment period, its still in your best interest to submit an application as soon as possible if you find out that youll be losing your Medicaid coverage. Written by Diane Archer. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. Can I use my Medicaid coverage in any state? 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. The Biden administration extended the U.S. coronavirus public health emergency, now more than two years old, for another 90 days on Wednesday. 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. With respect to Medicare: We do not offer every plan available in your area. Were providing certainty to states and giving them a gradual stream of funding and guardrail requirements that protect people. While nearly all states accept information by mail and in person, slightly fewer provide options for individuals to submit information over the phone (39 states) or through online accounts (41 states). The COVID SEP ended in most states. 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. How many people will lose Medicaid coverage when the continuous coverage requirement ends? endstream endobj startxref On April 12, 2022, the Secretary of Health and Human Services (HHS), Xavier Becerra, announced the extension of the public health emergency (PHE) related to the Coronavirus Disease 2019 (COVID-19) pandemic. The 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. 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. (PHE) ends. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). Heres what enrollees need to know. This 152-day extension then ends on October 9. Preparing for the End of COVID-19: Return to Regular Renewals . 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. hb```+@(1IAcfK9[<6k`cts``NaPsg@uQVH(pGS 4)NtQlqV~T~(plUUv=@\8\:\4?LqB d for medical reasons related to the disaster or public health emergency, or who are otherwise absent from the state . 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. 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. CNN . If you dont have access to an employer-sponsored plan and you are eligible for marketplace subsidies (most people are), the best course of action is to enroll in a marketplace plan as soon as you know that your Medicaid coverage will be terminated, in order to avoid or minimize a gap in coverage. For a person who is no longer Medicaid-eligible under normal rules, Medicaid coverage can end as early as April 1, 2023. hbbd``b`$ = $: " Ms ]@B#F_ E+ If BBB had been enacted in December, states would have had three months to get ready. In the second quarter, that will drop to 5 percentage points. 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. Starting April 1, 2023, states can resume Medicaid disenrollments. 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. As of January 10, 2023, CMS had approved a total of 158 waivers for 41 states (Figure 6). Total Medicaid/CHIP enrollment grew to 90.9 million in September 2022 . Herstate health exchange updatesare regularly cited by media who cover health reform and by other health insurance experts. 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 a result, in order for these waivers to continue, Congress must act and pass legislation making these waivers permanent. 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. (Prior to the pandemic, states had to recheck each enrollees eligibility at least once per year, and disenroll people who were no longer eligible. As a result, individuals who were enrolled in HUSKY Health may have their benefits extended . 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. 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). During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. Save my name, email, and website in this browser for the next time I comment. The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. At that time, they will be required to conduct a full renewal based on current circumstances before disenrolling anyone. uyx'tE!~YV.v.wDO @:Z98-PtinB*[Elrcr[b8B9NX5IR'[UC.ok"zf3itMAiP((ISh. Even though Congress could still enact some version of the BBB provisions relating to the unwinding of the continuous enrollment requirement, some states would find an April 1, 2022 renewal start date challenging. We are decoupling the Medicaid continuous eligibility policy from the Public Health Emergency. 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). What should you do if you currently have Medicaid coverage? Additionally, people with LEP and people with disabilities are more likely to encounter challenges due to language and other barriers accessing information in needed formats. 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 . The Biden administration announced its intention to end the federal public health emergency on May 11, 2023. V,wfBt3 [ho Read about your data and privacy. 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. 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. However, the Administrations superseding debt forgiveness program is still pending in the courts. But the situation is evolvingas of February 3, 2023, 41 states had posted their full plan or a summary of their plan publicly. But enrollment has trended upward throughout the pandemic, without the normal disenrollments that previously stemmed from the regular Medicaid eligibility redetermination process. Some people who will lose Medicaid eligibility are now eligible for Medicare instead. 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 end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. 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. Browse plans and costs with an easy, anonymous online tool. 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 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. 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). 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. The PHE has been in place since January 27, 2020, and renewed throughout the pandemic. Moreover, research shows that when parents gained coverage under the Medicaid expansion, Medicaid participation among their eligible but unenrolled children also increased. The move will maintain a range of health benefits . By preventing states from disenrolling people from coverage, the continuous enrollment provision has helped to preserve coverage during the pandemic. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be . Without it, millions of additional Americans would have joined the ranks of the uninsured. Can you appeal your states decision to disenroll you? Low-income enrollees will able to enroll in ACA coverage during a special enrollment period. HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. At the start of the pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA), which included a requirement that Medicaid programs keep people continuously enrolled through the end of the month in which the COVID-19 public health emergency (PHE) ends, in exchange for enhanced federal funding. 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. 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). | T p{YWY4,;U|p9 Tate Reeves, after months of resistance, asks lawmakers to pass postpartum Medicaid extension by Bobby Harrison February 26, 2023 February 26, 2023. A nationwide public health emergency is in effect. 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). Dont panic, but also dont delay, as your opportunity to enroll in new coverage will likely be time-limited. 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. People who can't access the website or who . 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 ARP is still making premiums more affordable. Many states have continued to send out these renewal notifications and information requests throughout the pandemic (nearly all states have been conducting automatic (ex parte) renewals when possible, and more than half the states have also been sending renewal forms to enrollees). The 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. For the first quarter of 2023, states will continue to get the 6.2 percentage point boost that theyve been receiving throughout the pandemic. For people whose income has increased enough to make them ineligible for Medicaid, but still eligible for this special enrollment period, there will be more flexibility in terms of access to coverage. HHS projects that nearly 8% of current Medicaid enrollees will lose their coverage despite continuing to be eligible once eligibility redeterminations resume. 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. including education, public health, justice, environment, equity, and, . 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. Healthcare Dive reports that the majority of people with Medicaid do not know that their coverage could end when the public health emergency ends. 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. Meghana Ammula By law, public health emergencies are declared in 90-day increments. 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. 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. 541 0 obj <>stream Its noteworthy that the additional federal Medicaid funding that states have received is more than double the extra cost that states have incurred to cover the FFCRA-related enrollment growth. Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. center between 2018 and 2022 . Filling the need for trusted information on national health issues, Jennifer Tolbert and 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. A trusted independent health insurance guide since 1994. The recent CIB notes that CMS is expected to issue guidance to address how new reporting requirements (discussed below) may intersect with the requirements described in prior CMS guidance. (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.). 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. And some states that also offer additional state-funded subsidies allow people with higher incomes to enroll year-round. 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