State Health and Value Strategies (SHVS) developed this resource page to serve as an accessible one-stop source of information for states in “unwinding” the Medicaid continuous coverage requirement. The Families First Coronavirus Response Act (FFCRA) Medicaid continuous coverage requirement allowed people to retain Medicaid coverage and get needed care during the pandemic. On December 29, 2022, President Biden signed into law the Consolidated Appropriations Act, 2023 (CAA), an omnibus funding package that decoupled the continuous coverage provision from the end of the COVID-19 public health emergency by providing a fixed end date of March 31, 2023. These resources are designed to support states during this major coverage event, including developing processes that prioritize coverage retention. SHVS will update this page frequently with new resources as they become available. For more information about how states are unwinding the continuous coverage requirement, SHVS is highlighting examples of the work states are engaging in to prepare for and operationalize unwinding in our series States of Unwinding.
State Health and Value Strategies (SHVS) developed this resource page to serve as an accessible one-stop source of information for states in “unwinding” the Medicaid continuous coverage requirement. The Families First Coronavirus Response Act (FFCRA) Medicaid continuous coverage requirement allowed people to retain Medicaid coverage and get needed care during the pandemic. On December 29, 2022, President Biden signed into law the Consolidated Appropriations Act, 2023 (CAA), an omnibus funding package that decoupled the continuous coverage provision from the end of the COVID-19 public health emergency by providing a fixed end date of March 31, 2023. These resources are designed to support states during this major coverage event, including developing processes that prioritize coverage retention. SHVS will update this page frequently with new resources as they become available. For more information about how states are unwinding the continuous coverage requirement, SHVS is highlighting examples of the work states are engaging in to prepare for and operationalize unwinding in our series States of Unwinding.
On Thursday, November 16, State Health and Value Strategies hosted a webinar on provisions included in the Consolidated Appropriations Act, 2023 (CAA) that require states to provide children up to age 19 with 12 months of continuous enrollment (CE) in Medicaid and the Children’s Health Insurance Program starting January 1, 2024. During the webinar, experts from Manatt Health reviewed recent sub-regulatory guidance from the Centers for Medicare & Medicaid Services and considerations for states as they prepare to newly take up CE for children or modify existing CE policies to meet the CAA requirement.
This expert perspective provides insights on the temporary section 1902(e)(14) waiver flexibilities that may be valuable for the Centers for Medicare & Medicaid Services to consider extending or authorizing permanently to streamline and improve post-unwinding renewal processes. An informal and anonymous survey conducted by State Health and Value Strategies (SHVS) asked states to rate the value of these flexibilities during unwinding and their level of interest in making flexibilities permanent. Findings are not representative of all states and should be interpreted with caution.
During the unwinding of the Medicaid continuous coverage requirement there has been a strong focus on monitoring the impacts of eligibility redeterminations. A review of public unwinding data identified nine states that are voluntarily reporting Medicaid reinstatement data—including reinstatements as a result of CMS guidance on conducting ex parte at the individual level, as a result of fair hearing cases, or re-enrollment into Medicaid and the Children’s Health Insurance Program within the 90-day reconsideration period. This expert perspective reviews current state reporting of reinstatement data and provides recommendations for the reporting of such data.
This CMS chart identifies states that requested concurrence to delay procedural disenrollments for enrollees during the return to routine Medicaid renewals period, including information on the number of months for the delay, the duration of the authority, and affected populations. This chart only identifies states that have opted to pause procedural disenrollments to allow time for targeted outreach. It does not identify states that received CMS approval to delay procedural disenrollments as part of a mitigation strategy.
The Centers for Medicare & Medicaid Services released new data related to the unwinding of the federal Medicaid continuous coverage requirement, along with additional unwinding resources. This expert perspective reviews newly available Medicaid, Children’s Health Insurance Program (CHIP), and Marketplace data, and summarizes key findings pertaining to Medicaid and CHIP enrollment, applications, and renewals, as well as Marketplace transitions.
CMS published a slide deck that provides further information on operationalizing continuous eligibility for children after an ex parte renewal.
Many states are actively working to make changes to their systems to enable ex parte renewals at the individual level and implement mitigation strategies to ensure eligible Medicaid and CHIP enrollees retain coverage until those system changes are complete. This tool is intended to: (1) help states identify common policies and/or operational processes that, if adjusted, could improve ex parte rates and renewal functionality, and (2) facilitate internal, cross-divisional Medicaid agency discussions across policy, operational, and information technology systems.
CMS published an interactive map and updated table of the section 1902(e)(14) waivers approved for states and territories to facilitate unwinding, including strategies to support ex parte processes.
The New Mexico Human Services Department (HSD) announced the agency is providing an additional 30 days for Medicaid enrollees to submit their renewal applications. The agency is also seeking CMS approval for an additional strategy to mitigate loss of coverage at renewal for children ages zero to six.
The open enrollment period (OEP) for health insurance Marketplaces will run from November 2023 to January 2024. This OEP will take place while most states are also conducting Medicaid renewals during the unwinding of the Medicaid continuous coverage requirement. State Health and Value Strategies has created sample messages and accompanying social media graphics to support states during the simultaneous Medicaid unwinding and open enrollment period. States can use this content in their outreach efforts to communicate important Marketplace enrollment opportunities to consumers, including those that may transition from Medicaid coverage.
As many states are implementing mitigation strategies to ensure compliance with the federal requirement to conduct ex parte renewals at the individual level, SHVS created model Medicaid reinstatement notice language which is intended to provide states with models for communicating key information to enrollees regarding their reinstatement. States can tailor and modify the templates for their programs and specific mitigation plans. The expert perspective also includes tips for writing and disseminating effective notices, based on enrollee feedback.
The Nebraska Department of Health and Human Services Division of Medicaid and Long-Term Care will host the next Medicaid listening tour throughout October and November 2023 in communities around the state. During the listening tour—which will include 12 meetings in 10 cities throughout Nebraska, along with two virtual sessions—Nebraska Medicaid will be announcing upcoming changes to the program and providing updates on the continuous coverage unwind.
The Colorado Department of Health Care Policy and Financing announced changes to its renewal packets to reflect feedback from members and advocates. Changes will be reflected in renewal packets sent mid-October, including fewer blank spaces and fewer pages, additional emphasis to sign the renewal packet, and the addition of a color Colorado state seal to the renewal packet envelope window to help prevent it from being mistaken for junk mail.
This expert perspective summarizes CMS’ recently released State Health Official letter providing guidance on the requirement in the Consolidated Appropriations Act, 2023 (CAA) that all states must adopt 12-months of continuous enrollment (CE) for children effective January 1, 2024. Key topics addressed in the guidance include the specific eligibility groups subject to CE under the CAA, the limited exceptions under which CE may be discontinued prior to 12 months, the impact of CE on children in carceral settings, and implementation requirements for states.
On September 29, the Centers and Medicare & Medicaid (CMS) published a new release of state-reported Medicaid unwinding data through its Unwinding and Returning to Regular Operations after COVID-19 landing page. Like previous releases of data, CMS includes national and state-specific metrics pertaining to Medicaid and CHIP eligibility renewal outcomes and total enrollment in June (and preliminary data for July). This month, as part of its timeline of planned data releases, CMS newly shared more comprehensive data on Marketplace enrollment and transitions—including cumulative enrollment data between April and June for HealthCare.gov, State-Based Marketplaces, and the Basic Health Programs—and separate CHIP enrollment in April 2023.
To renew enrollees’ Medicaid coverage, states must first attempt to confirm ongoing eligibility using data available to the agency without requiring information from the individual. This requirement, also known as ex parte renewals, can reduce the administrative burden for states and simplify the process for enrollees. To understand the barriers to successful ex parte renewals and opportunities to improve them, the Medicaid and CHIP Payment Access Commission (MACPAC) contracted with Mathematica to conduct a roundtable with federal and state Medicaid officials and subject matter experts in June 2023. This issue brief describes the key themes and opportunities for improvement that emerged during the roundtable. Overall, participants agreed that improving the ex parte process in an important goal, but that there are a number of factors that complicate implementation and the issues may take some time to resolve.
In a new National Association of Medicaid Directors (NAMD) blog post, NAMD Executive Director Kate McEvoy discusses the current state of Medicaid unwinding and lifts up where priorities at all levels are aligned and what states are doing to innovate and course correct to improve the redetermination process for Medicaid members. McEvoy emphasizes that state and territory Medicaid staff are central to this effort and remain actively and dynamically at work. This includes learning from unwinding data and experience, issue spotting and responding to feedback from members and partners, and proactively collaborating with both federal partners and the myriad entities—managed care organizations, healthcare providers, community-based organizations, and advocates—that are essential to achieving the shared goal of coverage retention.
The Oregon Health Authority announced that their latest renewal data continues to show that more than 7 out of 10 Oregonians are keeping their Oregon Health Plan or other Medicaid benefits. So far, around one in eight people’s benefits are ending. Compared with other states, Oregon has the third lowest benefit closure rate in the nation among completed renewals.
The Department of Health and Human Services announced that it reinstated coverage for Nevadans who recently had their coverage end because they did not return their renewal documentation. Due to a change in federal direction on policy in August, the Division of Welfare and Supportive Services (DWSS) was able to reinstate coverage for approximately 114,000 individuals. Individuals whose Medicaid coverage was reinstated this week will receive a notice in the mail from DWSS.
The Michigan Department of Health and Human Services (MDHHS) is extending the renewal of enrollees undergoing life-saving treatment through May 2024 to ensure these enrollees can keep their healthcare coverage and complete their treatment. The extension for those receiving life-saving treatment applies to enrollees undergoing chemotherapy, radiation, immunotherapy infusions or dialysis who are not able to be renewed through ex parte and do not have other comprehensive health insurance coverage, like Medicare.
As states are working diligently to operationalize the unwinding of the Medicaid continuous coverage requirement, State Health and Value Strategies has been tracking the creative strategies states are implementing to minimize coverage losses. This expert perspective highlights all the hard work states are engaged in and spotlights innovative strategies other states may want to consider adopting. SHVS will continue to track and share state efforts to support coverage through the unwinding period. If your state is implementing a new effort to reach enrollees, or if you have questions about how you can implement an example included in this EP, please be in touch.
CMS published preliminary state-reported information about the ability of states’ systems to conduct automatic renewals, otherwise known as ex parte renewals, at the individual level. As of September 21, 23 states and territories attested to correctly conducting ex parte renewals at the individual level, while 30 states and territories indicated they are not doing so or are still working to reinstate affected individuals. In a press release, CMS announced that all 30 states and territories are required to pause procedural disenrollments for impacted people unless they can ensure all eligible people are not improperly disenrolled as a result of the systems issue.
CMS published a table that presents preliminary state-reported information about the ability of states’ systems to conduct automatic renewals, otherwise known as ex parte renewals, at the individual level. As of September 21, 23 states and territories attested to correctly conducting ex parte renewals at the individual level, while 30 states and territories indicated they are not doing so or are still working to reinstate affected individuals.
Given the potential to reduce coverage losses during the unwinding, there is intense interest in data that monitors transitions between Medicaid and Marketplace coverage. State-Based Marketplaces (SBMs) that operate their own eligibility platform should consider releasing available data on Marketplace transition outcomes. This expert perspective highlights recommendations for SBMs, such as providing context and making the data easy to find. The expert perspective includes an interactive map with links to SBMs reporting Marketplace transition outcome data and a table of the indicators that states are reporting on. SHVS will continue to update this EP as more SBMs publish unwinding data.
The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act, with significant health equity implications. Given the intense focus on coverage transitions during the unwinding, some states are publishing their data to monitor progress. To date, 42 states (including the District of Columbia) have released unwinding data in either an interactive dashboard or static pdf format, or are making public their required CMS Monthly Unwinding Data reports. This expert perspective includes an interactive map with links to state dashboards and reports to CMS. SHVS will continue to update this EP as more states publish their unwinding data.
On August 30, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director Letter (SMDL) instructing states to assess whether they are in compliance with federal Medicaid regulations that require all renewal processes be conducted at the individual level. This expert perspective summarizes the SMDL, which lays out immediate actions that states must take to determine if they are out of compliance with the federal renewal requirements and mitigate compliance issues.
This diagnostic assessment tool is designed to assist states in assessing whether they are conducting ex parte and other renewal processes at the individual level in accordance with federal regulatory requirements. To use this tool, states should convene a team of key policy, operations and systems owners to review and answer these questions. This will require close review and analysis of eligibility and enrollment policies, IT system business rules and other system artifacts, and operating procedures.
CMS issued a State Medicaid Director Letter (SMDL) instructing states to assess whether they are in compliance with federal Medicaid regulations that require all renewal processes be conducted at the individual level.
CMS is calling to action every state and federal agency that works with children and families to engage directly and through partners during the unwinding to maintain coverage.
The Minnesota Department of Human Services announced that nearly 50,000 Minnesotans took action to renew their Medicaid or MinnesotaCare (the state’s basic health program) coverage in the state’s first group to renew coverage since the COVID-19 pandemic. Coverage was extended until the fall for 10,000 enrollees who get their coverage based on having a disability, being blind or being aged 65 years or older as part of the state’s mitigation plan with CMS. Medicaid coverage ended for about 5,600 people who submitted forms and were found ineligible and for about 32,600 people whose status is unknown.
The Kentucky Health Benefit Exchange created a “Back-to-School” outreach flier to inform families who are enrolled in Medicaid or CHIP coverage that their renewal letter will be coming soon and the actions they need to take to remain covered. The flyer, which is also available in Spanish, includes contact information and a QR code directing individuals to more information about the unwinding.
The Arkansas Department of Human Services released its July report on Medicaid unwinding. In July, more than 50,000 cases were renewed after eligibility was confirmed, and 82,279 enrollees were disenrolled.
Medicaid, CHIP, Marketplace and integrated human services call centers are experiencing a surge in the number of callers seeking information about their health coverage with the end of the Medicaid continuous coverage requirement. In some states, high call volume is translating into long wait times and high rates of call abandonment, adversely affecting Medicaid and CHIP enrollees who rely on the call center as a critical source of assistance and support. Recognizing the crucial role of call centers in supporting enrollees throughout the eligibility and enrollment process, states can use this toolkit to identify opportunities and explore strategies to improve call center functionality.
A secret shopper study conducted by researchers at Georgetown University suggests that former Medicaid enrollees searching for new health plans on the private market are facing aggressive and misleading marketing of limited benefit products that fail to protect consumers from the steep cost of healthcare. The study conducted in June 2023 indicates that online searches for health insurance led to websites and solicitations from sales representatives promoting limited benefit products, rather than the Affordable Care Act Marketplace.
The Institute for Medicaid Innovation released findings from their survey of Medicaid health plans. The survey, supported by the Robert Wood Johnson Foundation, asked plans how they are handling the redetermination process in an effort to identify best practices. The national survey captures information that can be used to inform federal and state policymaking and provides insight on the barriers, challenges, and successes health plans are experiencing related to Medicaid redeterminations. This is the first in a four-part series of surveys related to the unwinding of the Medicaid continuous coverage requirement.
The Wisconsin Department of Health Services launched a new webpage showing statewide Medicaid enrollment data following the end of the continuous coverage requirement. The data on the new webpage show that in June, 99,037 members were due to renew their coverage and 61,057 members took some action to initiate the renewal process.
The New York State Department of Health released the first issue of the state’s “Public Health Emergency Unwind Dashboard,” a monthly report reflecting data on renewal status, demographics and program transitions for public health insurance enrollees. The report indicates that roughly 72% of New Yorkers enrolled in Medicaid, Child Health Plus or the Essential Plan renewed their coverage before the June deadline to re-enroll.
The Georgetown University’s Center for Children and Families released a new interactive chart of state unwinding renewal data. The chart shows the share of ex parte renewals in which coverage is automatically renewed for an individual based on information in the enrollee’s case file or electronic data sources and the enrollee is not required to return a form or take action to maintain Medicaid coverage. This resource also shows the share of people being disenrolled for procedural versus eligibility reasons and the share of pending cases.
The Wyoming Department of Health is reminding Medicaid enrollees, family members, providers and case managers that services provided to certain populations through waiver programs are part of Wyoming Medicaid and individuals need to return their renewal forms to avoid loss of coverage.
The Mississippi Division of Medicaid announced that approximately 56% of the enrollees in the June review month retained coverage. Of the more than 29,000 who were disenrolled, at least 60% were individuals whose coverage had previously been extended because of the special eligibility rules during the public health emergency.
The Minnesota Department of Human Services announced that efforts to reach enrollees regarding Medicaid unwinding have so far included over 92,000 text messages and 290,000 paper notices through the mail. Partners are also reaching out through direct phone calls, texts, emails and in-person contacts in some locations.
The Michigan Department of Health and Human Services (MDHHS) announced that as of July 6, the state renewed Medicaid coverage for 103,540 people. That includes 30,456 renewals for enrollees who submitted their paperwork and 73,084 for people who were renewed by MDHHS because the department already had necessary information required for eligibility.
The Maryland Department of Health announced that 28,694 individuals were disenrolled from Medicaid in June: 17,075 were disenrolled for procedural reasons while 11,619 were disenrolled because they are no longer eligible for coverage. Of the 98,630 individuals whose eligibility was renewed, 53.5% had their eligibility auto-renewed.
CMS published a summary of the mitigation strategies 35 states adopted to comply with Medicaid renewal requirements. The summary highlights specific areas where states were deemed out of compliance with the federal renewal requirements, and states’ primary, high-level mitigation strategies. Of note, nine states paused procedural terminations as part of their mitigation plan and 16 states did not identify areas of non-compliance and therefore did not adopt mitigation strategies.
The Minnesota Department of Human Services is sending $36 million to support county and Tribal efforts to renew Minnesotans’ health insurance. The funds will cover costs such as addressing health disparities, hiring and training staff, paying overtime and reaching out to enrollees.
The Arkansas Department of Human Services released its June report on Medicaid unwinding. In June, more than 50,000 cases were renewed after eligibility was confirmed, and approximately 77,000 enrollees were disenrolled.
The Arizona Health Care Cost Containment System (AHCCCS) released its monthly Medicaid renewal data dashboard detailing progress since the regular renewal process began in April. In the month of June, 67% of the renewals initiated were automatically determined to be eligible to maintain AHCCCS coverage. Approximately 25% of all individuals who have been disenrolled for not responding to AHCCCS have taken advantage of the 90-day window to finish their renewal.
The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act, with significant health equity implications. Given the intense focus on coverage transitions during the unwinding, some states are publishing their data to monitor progress. To date, 32 states and the District of Columbia have released unwinding data in either an interactive dashboard or static pdf format, or are making public their required CMS Monthly Unwinding Data reports. This expert perspective includes an interactive map with links to state dashboards and reports to CMS. SHVS will continue to update this EP as more states publish their unwinding data.
CMS has granted Alaska additional time (18 months) to initiate renewals due to state-specific challenges and the need to prevent inappropriate losses of coverage.
A slide deck with account transfer strategies. CMS encourages states with State-Based Marketplaces to consider exchanging information on procedural terminations and jointly conducting outreach—including with regard to the 90-day reconsideration period for individuals terminated from Medicaid/CHIP.
An updated timeline chart with revised information on the month in which states initiated renewals and began processing terminations of Medicaid and CHIP coverage for individuals determined ineligible. The chart newly includes detail on the states that are prioritizing redeterminations for individuals they have identified as likely ineligible for Medicaid/CHIP.
CMS released frequently asked questions for state Medicaid and CHIP agencies on FMAP reduction and the failure to meet reporting requirements
New York State of Health, the state’s official health insurance Marketplace, created a webpage with information for employers on the unwinding. The webpage includes information for employers that offer insurance coverage to their employees and where to direct employees if employer-sponsored coverage is not offered. Resources include a fact sheet for employees, frequently asked questions for employers and a letter to employers on redeterminations and coverage.
Nevada Health Link, the state’s official health insurance Marketplace, Nevada Medicaid and the Division of Welfare and Supportive Services issued a press release about how the state agencies are working together to keep Nevadans insured during the unwinding. During the months of April and May, 94% of those who applied for health coverage after being transferred to the Marketplace from Medicaid were found eligible to enroll, and 74% of those who applied were additionally found eligible for financial assistance.
The Minnesota Department of Human Services announced it will extend the deadline to renew Medicaid for 35,500 people whose renewal paperwork is overdue for July 1 coverage. The state is working with the federal government to avoid ending coverage for people who may still qualify, but face barriers such as not receiving the form in the mail.
The Massachusetts Health Connector, the state’s official health insurance Marketplace, shared an update on Medicaid redeterminations and transitions to the Heath Connector during a June 8 board of directors meeting. As of June 5, a total of 34,645 individuals were found eligible for Marketplace coverage and 7,997 individuals, or 23%, enrolled in a plan.
The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act, with significant health equity implications. Given the intense focus on coverage transitions during the unwinding, some states are publishing their data to monitor progress. To date, 29 states and the District of Columbia have released unwinding data in either an interactive dashboard or static pdf format, or are making public their required CMS Monthly Unwinding Data reports. This expert perspective includes an interactive map with links to state dashboards and reports to CMS. SHVS will continue to update this EP as more states publish their unwinding data.
The Oregon Health Authority announced the most recent eligibility review data show that nearly 7 in 10 Oregonians, whose eligibility for the Oregon Health Plan and other state Medicaid programs has been reviewed in recent months, have maintained health coverage. In May, 164,873 people came up for renewal and 108,343 people had their coverage renewed without needing action from the member.
Following the announcement last week by CMS of new strategies states can employ to minimize the loss of coverage for procedural reasons, Michigan announced it will leverage the new federal flexibilities.
The Wisconsin Department of Health Services (DHS) is encouraging Medicaid members to submit their renewals at the “just right” time to avoid delays or gaps in coverage. DHS announced a new renewal status webpage with instructions for Medicaid enrollees to find their renewal month and allowing them to sign up for renewal reminders.
The South Carolina Department of Health and Human Services (SCDHHS) issued a bulletin to providers stating that only 30% of Medicaid enrollees returned eligibility review forms that the state sent out as part of the redeterminations process, which began April 1. SCDHHS is seeking providers’ help in encouraging Medicaid-enrolled patients to submit their renewals.
The Maryland Department of Health announced the initial data from the first round of Medicaid renewals. For the month of May, Maryland Medicaid processed 119,803 renewals. Of these, 76,104 were determined eligible to have their coverage extended; 10,032 were determined to be not eligible based on information provided and were disenrolled; and 24,643 were disenrolled for procedural reasons, such as not updating eligibility information.
The Kentucky Health Benefit Exchange released its June monthly unwinding data report. The report includes data on processing applications, initiated renewals, and renewal outcomes.
The Kentucky Cabinet for Health and Family Services released a Medicaid renewals snapshot as of June 1, which includes data on the number of passive and active renewals, the number of mailed notices and emails the state has sent, phone calls made to Medicaid members, and the anticipated renewal case counts for each month through April 2024.
The Arkansas Department of Human Services released updated figures reflecting the second month of Medicaid redeterminations. The state disenrolled 68,838 Medicaid enrollees in May.
This CMS resource includes an updated List of State Section 1902(e)(14) Waiver Approvals, shedding light on the way in which states have approached these temporary waivers, including the number of strategies adopted (ranging from 0 up to 11) as well as the types of strategies that states have implemented.
This CMS resource urges partner efforts to promote coverage retention.
This unwinding update from CMS urges efforts to promote coverage retention and includes a data update based on CMS’ preliminary analysis from 18 states that completed renewals in April.
This resource details new or updated section 1902(e)(14) waiver strategies, such as delaying procedural terminations for enrollees for one month while the state conducts targeted renewal outreach and designating state agencies or pharmacies as qualified entities to make presumptive eligibility determinations for individuals disenrolled from Medicaid or CHIP for procedural reasons.
HHS Secretary Becerra issued a letter to governors in response to early state data on Medicaid redetermination outcomes. The letter expresses concern related to high rates of disenrollments for procedural reasons as well as coverage loss among children, and encourages states to redouble efforts to (1) leverage additional, temporary flexibilities to support unwinding; and (2) partner with stakeholders to protect against inappropriate coverage loss.
North Dakota Health and Human Services announced that about 13,100 North Dakota Medicaid members were due for a renewal on May 31, and only about one in three members who were sent a renewal form returned it. As a result, 4,421 people were disenrolled.
The Idaho Department of Health and Welfare announced that the state has processed 91,350 Medicaid renewals, of which 25,070 individuals were determined eligible and 66,280 were found ineligible or did not respond to their renewal.
The Massachusetts Health Connector, the state’s official health insurance Marketplace, will be publishing reports to provide comprehensive and up-to-date information on plan selection, contact center summaries, and enrollment data during the unwinding. The first summary report was published on May 28.
CoverME.gov, the state’s official health insurance Marketplace, created a consumer enrollment guide for individuals no longer eligible for Medicaid during the unwinding. The guide instructs individuals on how to create an account, access an existing application that the Department of Health and Human Services may have sent to the Marketplace, enroll in the special enrollment period available for those who lost Medicaid, choose a plan, and access financial assistance through the Marketplace.
Kentucky is hosting monthly stakeholder meetings throughout the unwinding of the Medicaid continuous coverage requirement. During the May stakeholder meeting, the Cabinet for Health and Family Services presented on the state’s renewal caseload planning, priorities, renewal updates, outreach, reporting to CMS, and how providers can support patients through renewals.
Oregon has created several resources aimed at employers to help keep people covered during the unwinding. The resources include a flyer for employers on coverage available through the Marketplace, a flyer for employees losing Medicaid benefits to inform them of both employer-sponsored coverage and the Marketplace and suggested newsletter text for employer or association newsletters.
The New Hampshire Department of Health and Human Services released a report on Medicaid enrollment which shows that total enrollment declined 10.8% from March to April. The total number of disenrollments for this period was 27,217.
For individuals who receive a notice that they are no longer eligible for Medicaid or MinnesotaCare, MNsure has created a guide on how to get new coverage through the Marketplace with information about the available special enrollment period, free enrollment help through a MNsure-certified assister, and available financial assistance through the Marketplace.
MNsure, the state’s official health insurance Marketplace, created a webpage to assist individuals who need help replacing Medicaid or MinnesotaCare (the state’s Basic Health Program) coverage during the unwinding. The webpage directs consumers who are unsure about their eligibility renewal status to the Minnesota Department of Human Services’ webpage on renewals.
Beginning June 2023, Covered California, the state’s official health insurance Marketplace, will automatically select consumers losing Medicaid coverage into the lowest cost silver plan available to maximize premium tax credit and cost-sharing support. The program will ensure that consumers will not experience a gap in coverage if they effectuate their coverage within a month. Covered California will send customized notices to consumers to explain their plan enrollment and financial assistance and educational materials related to coverage, plan benefits, and key insurance terms. A dedicated website will be made available for consumers to direct them to their pre-selected plan and effectuation options, as well as a specialized phone support system with an interactive voice response menu and live assistance.
CCIIO released guidance that provides operational details for unwinding for enrollees in Marketplaces using the federal platform, which are also applicable to State-Based Marketplaces.
As states have begun reporting on changes in enrollment as a result of unwinding, the article highlights strategies states, the federal government and community partners can employ to limit the loss of coverage among people who are eligible, and connect individuals no longer eligible for Medicaid to other sources of coverage.
Dr. Richard Besser, President and CEO of the Robert Wood Johnson Foundation co-authored an op-ed highlighting that 5 million children are at risk of losing coverage as a result of the unwinding. The op-ed encourages governors to take measures to ensure eligible children maintain their coverage.
Host Heather Howard, a professor at Princeton University and former New Jersey Commissioner of Health and Senior Services, discusses the unprecedented transition with Kate McEvoy, Executive Director of the National Association of Medicaid Directors, and Dr. Kemi Alli, a pediatrician and Chief Executive Officer of Henry J. Austin Health Center, a federally qualified health center in Trenton, New Jersey. They talk about strategies for maximizing continuity of coverage for consumers — along with who is most likely to slip through the cracks, the role of state health officials and health care providers, and the potential impact on public health.
The New Jersey Department of Banking and Insurance Commissioner Marlene Caride announced the creation of an extended special enrollment period (SEP) for individuals who are no longer eligible for NJ FamilyCare (Medicaid) and qualify for health insurance through Get Covered New Jersey, the state’s official health insurance Marketplace. The department has established an extended SEP to allow these individuals 120 days to sign up for coverage and provides flexibilities that create a streamlined transition between the programs, offering consumers the option of having an earlier effective date of coverage to avoid coverage gaps.
Governor Gretchen Whitmer issued an executive directive instructing all state of Michigan departments to work together to help Michiganders keep Medicaid coverage or find affordable health insurance as Medicaid renewals begin. The executive directive instructs all state departments to assist the Department of Health and Human Services (DHHS) and the Department of Insurance and Financial Services (DIFS), by distributing information to Michiganders regarding the redetermination process and how to renew eligibility, and sharing necessary data to conduct outreach.
The Arkansas Department of Human Services reported figures reflecting the first month of redeterminations as part of its six-month Medicaid unwinding effort. The total number of disenrollments in April was 72,802.
To help states respond to the ongoing COVID-19 pandemic, the White House, the U.S. Department of Health and Human Services, and the Centers for Medicare and Medicaid Services have invoked their emergency powers to authorize temporary flexibilities in Medicaid and the Children’s Health Insurance Program. Congress’s legislative relief packages have provided additional federal support for state Medicaid programs, subject to certain conditions. The timeframes for these emergency measures are summarized in the chart, including the effective dates and expiration timelines dictated by law or agency guidance.
The state has created a consumer guide for individuals enrolling in coverage if their information was not transferred to the Marketplace.
The state has created a consumer guide for individuals enrolling in coverage if their account was transferred to the Marketplace.
GetCoveredNJ, the state’s official health insurance Marketplace, created a list of frequently asked questions (FAQs) on the loss of NJ FamilyCare (Medicaid/CHIP) during the unwinding. The FAQ informs enrollees of a 120 day special enrollment period to enroll in coverage through GetCoveredNJ after Medicaid or CHIP coverage ends.
The Colorado Division of Insurance issued an order regarding a Medicare Supplement guaranteed issue period for consumers losing Medicaid coverage due to the unwinding. This will allow individuals who became eligible for Medicare during the continuous coverage requirement and missed the open enrollment window to access Medicare Supplement plans during the unwinding.
The Minnesota Department of Human Services (DHS) has cancelled unpaid MinnesotaCare (the state’s Basic Health Program) premiums and will waive premiums for May 2023 through June 2024 coverage for all enrollees. The state passed legislation in 2021 that prevents DHS from collecting unpaid MinnesotaCare premiums that accrued during the public health emergency. Additionally, the 2023 Minnesota legislature passed a law that temporarily waives MinnesotaCare premiums for all enrollees for coverage from May 2023 through June 2024.
A new Kaiser Family Foundation (KFF) analysis estimates the number of people who could lose Medicaid during the unwinding period under three possible rates of Medicaid coverage loss, and shows for each illustrative rate, state-by-state coverage reductions among Medicaid children and adults. The KFF analysis uses a combination of enrollment data from the CMS Performance Indicator Project, Medicaid claims data, and some state-specific sources. In practice, rates of Medicaid coverage loss will vary across the states, depending on states’ approaches to the unwinding and the extent to which they engage in outreach and assistance activities to minimize disenrollment among people who are still eligible.
Successful transitions to the Marketplace are key to minimizing coverage loss during the Medicaid unwinding. In this expert insight for the Robert Wood Johnson Foundation’s Marketplace Pulse series, RWJF Senior Policy Advisor Katherine Hempstead examines the importance of successful transitions from Medicaid to the Marketplace, given that the percentage of Medicaid enrollees projected to lose their eligibility ranges across states from roughly 10% to 30%.
New Mexico has created the Medicaid Transition Premium Relief Program intended to support coverage transitions during the unwinding. Through the program, the first month’s premium may be paid for most people moving from Medicaid to beWellnm, the state’s official health insurance Marketplace. The program is meant to minimize coverage disruptions and lock-in consumer protections for qualifying individuals and families who need affordable coverage.
This document provides responses to questions asked during the March 2023 public stakeholder meetings. As additional questions are received, the Department for Medicaid Services (DMS) will update this FAQ accordingly.
This plan outlines Kentucky’s planned approach and processes to achieve three PHE unwinding goals: comply with CMS requirements, prevent administrative terminations, and transition ineligible individuals to alternative coverage.
The Marketplace has step-by-step instructions for individuals enrolling in Marketplace coverage without a referral during the unwinding.
The Marketplace has step-by-step instructions for individuals referred from Medicaid to the Marketplace during the unwinding.
Your Health Idaho, the state’s official health insurance Marketplace, released frequently asked questions (FAQs) on the Medicaid continuous coverage unwinding that address topics such as what happens to someone who has lost coverage and what actions they need to take in order to maintain or transition to another source of coverage.
These infographics provide an overview of the key changes to the parameters for unwinding enacted by the CAA as well as an illustrative continuous coverage unwinding timeline under the CAA. The infographics are intended to help states communicate internally or with key stakeholders about the Medicaid continuous enrollment condition provisions in the CAA and can be downloaded to use in communications.
The Texas Health and Human Services Commission (HHSC) announced that in order to handle the expected workload of Medicaid renewals, HHSC has increased its eligibility workforce through various recruitment and retention efforts, including hiring temporary staff to assist with the workload, implementing merit pay and salary adjustments, promoting flexible work schedules, and streamlining training requirements. Since April 2022, HHSC has added 1,000 eligibility staff to its workforce. This month, HHSC will begin mailing all Medicaid renewal notices in a yellow envelope that says “Action Required” in red. In addition to mailed notices, HHSC is using social media posts, online banner messages, flyers, emails, and text messages to notify enrollees about renewing their benefits. HHSC has supplied outreach tools to partner organizations or ambassadors to help spread the word about the end of continuous Medicaid coverage.
The South Carolina Department of Health and Human Services (SCDHHS) announced that Medicaid members who have provided SCDHHS with a cell phone number will receive a series of text messages to remind the member to return their annual review form. SCDHHS also released a new document upload tool which will allow members to provide requested information, report a change in income, return an annual review form or submit other documents. The information received through the tool will allow SCDHHS to contact members if there are any questions about the documents. Members may also continue to return their annual review form in-person or via mail, email, or fax.
New York received CMS approval for two 1902(e)(14) waivers: 1) to accept contact information from managed care plans without additional verification; and 2) “zero-income” renewal.
New York received CMS approval for two 1902(e)(14) waivers: 1) to accept contact information from managed care plans without additional verification; and 2) “zero-income” renewal.
Montana released a provider program notice which offers an overview of the various webinars for different provider types (e.g., behavioral health, home and community-based services). The state views providers as “a trusted source of information for Medicaid members” critical to letting members “know what they need to do to keep their coverage.”
Governor Tim Walz signed into law a bill providing resources to help eligible Minnesotans keep their Medicaid and MinnesotaCare health insurance. The bill provides state funding for the transition to regular Medicaid eligibility verification procedures, and $36 million to help county and tribal agencies process healthcare renewals.
The Idaho Department of Health and Welfare (DHW) announced it has processed Medicaid renewals for 32,898 individuals since the beginning of February. Of the total 32,898 people processed, 13,647 have been found to still be eligible, and 19,251 have been found to no longer be eligible. Those who are no longer eligible will lose coverage starting April 1. Those determined to have too much income to qualify for Medicaid are being referred to the state-based health insurance Marketplace, Your Health Idaho.
The California Department of Health Care Services (DHCS) released a toolkit in English and Spanish for DHCS Coverage Ambassadors and other partners to help encourage members of the COVID-19 Uninsured Group (UIG) program to enroll in ongoing health coverage through Medi-Cal (Medicaid) or Covered California (the state’s official health insurance Marketplace) after the UIG program ends. During the COVID-19 public health emergency (PHE), more than 500,000 Californians were able to obtain temporary health coverage for COVID testing and treatment through the UIG program, which will end with the end of the federal PHE.
The Department of Social Services and Access Health CT shared a comprehensive 12-month operational and outreach plan to redetermine eligibility for HUSKY Health (Medicaid) enrollees and resume routine public program operations. Less than a quarter of the approximately 434,000 Connecticut residents being redetermined are expected to no longer be eligible.
The Massachusetts Health Connector created a website dedicated to unwinding the Medicaid continuous coverage requirement that includes resources for individuals and families to take action to stay covered, resources for employers and employees, and a toolkit with member-facing materials for redeterminations.
Nevada Health Link, the state’s official health insurance Marketplace, announced an estimated 200,000 Nevadans may be redetermined ineligible for Medicaid benefits over the next 14 months. For individuals who are not renewed for Medicaid coverage, Medicaid will contact individuals to advise them of their account transfer and Nevada Health Link representatives will do active outreach to those individuals to help them with next steps regarding their account.
The New York State Department of Health announced that beginning this spring and continuing through spring 2024, more than 9 million New Yorkers enrolled in Medicaid, CHIP and the Essential Plan (the state’s Basic Health Program) will need to renew their health insurance. Renewal notices will be sent on a rolling basis and renewal deadlines will be based on the enrollees’ enrollment end dates and will range from June 30, 2023, through May 31, 2024. Consumers are encouraged to renew by the 15th of the month.
The National Health Law Program compiled a list of continuous coverage unwinding guidance and resources for advocates. Resources have been compiled from the Centers for Medicare & Medicaid Services (CMS), other federal agencies, and advocacy organizations, including the National Health Law Program.
This document provides a list of available guidance, tools, and resources that may be helpful to states as implement the CMS approved processes and procedures (mitigation strategies) needed to be considered compliant for the renewal provision of section 5131 of the Consolidated Appropriations Act, 2023. Resources are organized by renewal requirement.
Rhode Island offering mini grants to community partners to reach those most at risk during the renewal process.
Governor Dan McKee announced that the state expects about half of Medicaid renewals to be passive and require no action from the enrollee. The state is working with community partners and advocates to conduct outreach efforts ahead of eligibility redeterminations. Those who cannot be passively renewed will be broken down into monthly renewals beginning April 1, with the last group of renewals beginning in March 2024. Of note, families with children will not start their Medicaid renewal process until December.
The Louisiana Department of Health announced a series of webinars for providers on the end of Medicaid continuous coverage and the restart of Medicaid renewals.
The Louisiana Department of Health announced that Louisiana Medicaid will start using text messages to send members important reminders about their health insurance coverage. These text messages may include reminders about renewals and reminders to update contact information.
The Colorado Department of Health Care Policy & Financing announced they began sending text message reminders to Medicaid members who need to complete renewal paperwork to see if they still qualify for health coverage
The Kansas Department of Health and Environment announced that they have increased communication with KanCare (Medicaid) enrollees, healthcare providers, and other stakeholder groups in regular contact with the enrollee community to share information regarding the resumption of eligibility reviews. In addition, KanCare has updated its website to make it easier for people enrolled in Medicaid to update their contact information and complete the verification process.
Executive Director Kim Bimestefer of the Colorado Department of Health Care Policy & Financing (HCPF) issued a message to stakeholders on the end of the Medicaid continuous coverage requirement, describing the state’s compliance with CMS’ criteria for obtaining enhanced federal matching funds. The notice also shares communication resources, such as awareness posters and social media images, and encourages stakeholders’ active engagement in raising Medicaid enrollees’ awareness of the upcoming renewals and in helping connect those who no longer qualify to other forms of coverage.
The Department of Health Care Services announced that it submitted a section 1902(e)(14) waiver request to renew eligibility for non-Modified Adjusted Gross Income (non-MAGI) populations without requesting additional information and to disregard increases in assets since the last Medi-Cal (Medicaid) determination. This waiver—which will be effective retroactive to March 1, 2023 through December 31, 2023—will increase the number of non-MAGI-based individuals who will have their coverage renewed during unwinding. California is planning to eliminate the asset limit entirely on January 1, 2024.
The Tracking Medicaid Enrollment Growth During the COVID-19 Pandemic Databook provides a comprehensive, detailed look at Medicaid enrollment trends to-date. Using Medicaid enrollment data from over 40 states, the Databook provides a comprehensive, detailed look at Medicaid enrollment trends from the beginning of the COVID-19 pandemic through December 2022. The Databook provides enrollment detail by state across four eligibility categories: expansion adults, children (including those enrolled in CHIP), non-expansion adults, and aged, blind, and disabled individuals. It also compares enrollment trends across expansion and non-expansion states. While variations in states reporting mean that the enrollment numbers in this report are not necessarily comparable across states (and should not be summed across states), the data reported do allow states and others to track enrollment trends. As a companion to the Databook, Manatt Health authored an issue brief, The State of Medicaid Enrollment Approaching Continuous Coverage Unwinding, that summarizes key findings from an analysis of the Databook.
To maximize efforts to maintain coverage, state Medicaid agencies and Marketplaces can now leverage digital channels as part of their overall outreach and communications efforts. Rapidly evolving changes in consumer media consumption habits as well as shifts in digital channels, and the ability to leverage data sources, enables granular audience targeting and efficient use of resources. These can be incorporated into an overall integrated outreach and education campaign to maximize renewals and coverage retention.
The tool aims to help states qualify for the sustained enhanced Federal Medical Assistance Percentage, avoid corrective action imposed by CMS, promote continuity of coverage and care during unwinding, and make long-term improvements to eligibility and enrollment infrastructure.
The Oklahoma Health Care Authority outlined their plan to phase the eligibility redetermination process following the end of the continuous coverage requirement by population.
The California Department of Health Care Services (DHCS) launched a statewide public information, education, and outreach campaign to raise awareness about the upcoming return of the Medi-Cal (Medicaid) eligibility renewal process. The statewide campaign will run from February 2023 through June 2024 and will reach across traditional and digital media channels. DHCS also launched a landing page, KeepMediCalCoverage.org, where Medi-Cal members can find out about the renewal process and how to update their contact information. Local county offices will begin mailing letters to members in April to let them know if their Medi-Cal coverage was renewed automatically or if they need more information to process the renewal.
The long-expected return to Medicaid eligibility re-determinations and renewals, referred to as the “Medicaid unwinding,” has begun. This expert perspective provides a checklist of actions state-based marketplaces and state insurance departments can take, if they haven’t already, to reduce gaps in coverage and minimize disruptions in care. Many are designed to be temporary, and will be critical to helping people navigate an unprecedented period of disruption. Other actions involve policies or operational improvements that could reap long-term benefits by mitigating risks inherent in Medicaid-Marketplace “churn.”
This expert perspective summarizes a recent federal court ruling that impacted CMS’ enforcement of an interim final rule (IFR) that narrowed CMS’ interpretation of the Medicaid continuous coverage requirement in the Families First Coronavirus Response Act (FFCRA).
On Wednesday, February 8, State Health and Value Strategies hosted a webinar during which experts from Manatt Health reviewed CMS’ recently released State Health Official (SHO) letter related to “unwinding” the Medicaid continuous coverage guarantee, based on provisions included in section 5131 of the Consolidated Appropriations Act, 2023 (CAA).The webinar reviewed the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage as laid out in the SHO letter, and discussed key considerations for state policymakers. As a reminder, SHVS has created a single-stop resource page to support states as they plan for unwinding.
On January 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released a State Health Official (SHO) letter, “Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023.” This SHO letter is the second in a series of guidance related to section 5131 of the Consolidated Appropriations Act, 2023 (CAA), which established a fixed end date for the Medicaid continuous coverage requirement, a gradual phase-down for the enhanced federal match, and new guardrails for mitigating coverage loss for individuals who continue to be eligible.
Building on existing CMS guidance, the State Health Official letter details the requirements that states must comply with in order to receive the enhanced federal medical assistance percentage; clarifies expectations for states to comply with the Medicaid, CHIP, and marketplace reporting elements required by the CAA; and reviews implications of the CAA on select COVID-19 public health emergency-related flexibilities and authorities.
The Washington State Health Care Authority issued a notice about the end of Medicaid continuous coverage and the state’s expected timeline, with renewals beginning April 1, 2023.
The Virginia Department of Medical Assistance Services announced that some Virginia Medicaid members will receive renewal information in the mail beginning March 18, 2023, with disenrollments starting no earlier than April 30, 2023. The bulletin asks advocates to assist Medicaid members to understand the renewal process and complete any actions required as soon as possible.
The Department of Health Care Policy & Financing (HCPF) will be hosting an informational session on preparing for the end of the COVID-19 Public Health Emergency and its Continuous Coverage requirement. This webinar is geared toward community partners such as advocacy organizations, providers, and community organizations who may provide other assistance to Health First Colorado or CHP+ members (housing, social services, etc).
The Colorado Department of Health Care Policy & Financing issued an update to community partners on the return to renewals following the end of the Medicaid continuous coverage requirement, which includes information on the state’s timeline for unwinding continuous coverage, with noticing beginning in March and renewals due in May.
On January 23, 2023, the Federal Communications Commission issued an important ruling that provides states with new flexibility to support enrollee outreach and communication efforts as part of their processes to unwind the Medicaid continuous coverage requirement. The ruling permits state agencies and their partners to send text messages and make phone calls to individuals about enrollment-related issues not only for Medicaid but for other state-run health insurance programs, including marketplace coverage. This expert perspective reviews the ruling and implications for states.
The Federal Communications Commission issued a ruling that provides states with new flexibility to support enrollee outreach and communication efforts as part of their processes to unwind the Medicaid continuous coverage requirement.
The Nebraska Department of Health and Human Services announced that, in preparation for the resumption of Medicaid redeterminations, Nebraska Medicaid will take extra steps to reach its members including traditional letters, phone calls, and other outreach in partnership with its health plans. In partnership with provider and advocacy organizations, Nebraska Medicaid will be providing written materials in coordination with the organizations who have helped develop the materials for provider’s offices and other locations. Social media will also be used for outreach.
While much attention has been paid to how states can approach the unwinding of the continuous coverage requirement to prioritize the retention of Medicaid coverage and transitions to marketplace coverage, less attention has been paid to the role of employer-sponsored insurance. To get a sense for the size of the group that might have employer-sponsored coverage as an option, this issue brief discusses the proportion of individuals with an offer of employer-sponsored coverage by income and state, and the proportion of those offers that are considered affordable based on premium cost.
Many consumers will find the relationship between Medicaid, the marketplace, and employer-sponsored insurance to be more complicated than ever in 2023 as the unwinding of the continuous coverage requirement begins. Much of the focus of Medicaid unwinding planning in states and the federal government has been on helping eligible people keep Medicaid coverage and steering the millions of people losing Medicaid eligibility toward the health insurance marketplace. Less attention has been devoted to the millions of people who are expected to be eligible for employer-sponsored insurance when their Medicaid coverage ends. This issue brief discusses how state Medicaid agencies, state-based marketplaces, labor departments, and employers can play critical roles in helping people understand and navigate their coverage options.
On Wednesday, January 11 State Health and Value Strategies hosted a webinar on the Consolidated Appropriations Act, 2023, an omnibus funding package that includes government appropriations through September 30, 2023 as well as a number of health policy provisions. Included in the package is a date certain for the expiration of the Medicaid continuous coverage requirement, a gradual phase down of the Families First Coronavirus Response Act enhanced federal match rate, and new guardrails to protect against inappropriate coverage loss and smooth coverage transitions.
When the federal Medicaid continuous coverage requirement expires, states will be required to redetermine eligibility for over 90 million Medicaid enrollees, threatening the historic coverage gains achieved during the federal public health emergency (PHE). One of the most effective tools for states to mitigate coverage loss for eligible people during “unwinding” and beyond is ex parte redetermination. This Q&A is intended to serve as a resource for states looking to improve their current ex parte processes to support their efforts during unwinding and well beyond.
After weeks of negotiations during the lame duck session, Congress passed the Consolidated Appropriations Act, 2023, an omnibus funding package that includes government appropriations through September 30, 2023 as well as a number of health policy provisions. Among the health policies included in the package, section 5131 of the legislation provides a fixed end date for the Medicaid continuous coverage guarantee (March 31, 2023), a gradual phase down of the Families First Coronavirus Response Act (FFCRA) enhanced federal match rate, and new conditions, reporting requirements, and enforcement mechanisms to prioritize coverage retention and smooth coverage transitions during the “unwinding.” This expert perspective provides an overview of these unwinding provisions and considerations for states.
TennCare, the state’s Medicaid program, issued a press release following passage of the Consolidated Appropriations Act, 2023 stating that it will be required to reverify the eligibility status of everyone receiving TennCare or CoverKids benefits beginning April 1, 2023. TennCare estimates that more than 1.7 million Tennesseans will be impacted by the process.
CMS released an updated deck on Strategic Approaches to Engaging Managed Care Plans to Maximize Continuity of Coverage as States Resume Normal Eligibility and Enrollment Operations in Medicaid and the Children’s Health Insurance Program (CHIP), following the end of the COVID-19 Medicaid continuous enrollment requirement. The updated deck provides new examples and scenarios of ways health plans can engage with states and beneficiaries to support continuity of coverage during unwinding.
In a new report, The Impact of the COVID-19 Public Health Emergency Expiration on All Types of Health Coverage, the Urban Institute uses the latest avaliable administrative data on Medicaid enrollment and recent household survey data to estimate health coverage when the Medicaid continuous coverage requirement ends. The report estimates that if the PHE expires in April 2023, 18 million people will lose Medicaid coverage. Of these 18 million, 3.8 million people will be uninsured, and approximately one million people will enroll in non-group coverage, mainly marketplace coverage with premium tax credits (PTCs). The report further estimates that 1.5 million former Medicaid enrollees will be eligible for PTCs but will not enroll, due to barriers such as higher premiums than Medicaid or limited coordination between Medicaid agencies and the marketplaces. The Urban report discusses several state-specific factors that could affect coverage transitions after the PHE ends, such as differences in marketplace take-up and differences in the number of inappropriate disenrollments from Medicaid.
The Centers for Medicare & Medicaid Services (CMS) released a resource for states to support their unwinding efforts after the COVID-19 public health emergency ends. This slide deck provides states with information on what is required and allowed when transitioning children between Medicaid and CHIP programs.
The National Association of Medicaid Directors (NAMD) sent a letter to Congress requesting certainty around the timing and fiscal resources available to support the eligibility redeterminations that will follow the end of the continuous coverage requirement. In the letter, NAMD asks that Congress provide at least 120 days advance notice and also confirm that existing federal guidance on the redetermination period will not change.
The Department of Human Services announced it will award mini grants to community-based organizations (CBOs) to engage Medicaid enrollees in preparation for the end of the public health emergency. The mini grants will support CBOs’ outreach and engagement efforts and assistance with the renewal process.
On October 28, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Program: Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and other Revisions to Medicare Enrollment and Eligibility final rule. This rule creates a new Medicare special enrollment period (SEP) for individuals losing Medicaid eligibility and who did not enroll in Medicare on time.
State Health and Value Strategies is hosting a webinar Unwinding of the Public Health Emergency: What’s Next for States on Wednesday, November 2. The webinar will feature a discussion of the key considerations and requirements for state Medicaid/CHIP agencies at the end of the PHE, including making permanent or terminating temporary COVID-19 flexibilities and returning to normal eligibility and enrollment processes. Presenters will highlight the intersection with our dynamic policy environment, including the recent CMS Proposed Rule on Medicaid and CHIP Eligibility, Enrollment, and Renewal.
This expert perspective provides an overview of the eligibility and enrollment proposed rule released by CMS on August 31 and details how the proposed rule seeks to strengthen existing eligibility, enrollment, and renewal operational processes in an effort to close gaps in coverage and extend best practices identified by CMS and states in the course of preparing for unwinding the federal public health emergency (PHE). Comments on the proposed rule are due no later than November 7, 2022.
The Centers for Medicare & Medicaid Services (CMS) released a new set of COVID-19 Public Health Emergency (PHE) Unwinding Frequently Asked Questions (FAQs) on Medicaid.gov. These FAQs provide answers to queries CMS has received regarding guidance to support state efforts to unwind the continuous enrollment condition and other COVID-19 temporary authorities in Medicaid and CHIP after the PHE ends.
The Centers for Medicare & Medicaid Services (CMS) released a resource for states that adopted the optional COVID-19 group related to ending coverage when federal authority for the group expires on the last day of the COVID-19 public health emergency (PHE). This resource discusses coverage of the optional COVID-19 group, redetermination and notice strategies for the affected enrollees, and expectations for ending coverage in the group in states unwinding plans.
The Centers for Medicare & Medicaid Services (CMS) released a resource for states to support their unwinding efforts after the COVID-19 public health emergency ends. This slide deck provides background information on ex parte renewal requirements and considerations, and offers strategies states can use to increase ex parte renewal rates, and other strategies to better automate eligibility renewals.
For more than two years, states have maintained coverage of their Medicaid enrollees as a condition of receiving enhanced federal Medicaid funding under the Families First Coronavirus Response Act, resulting in considerable increases in coverage for all Americans, including pregnant and postpartum individuals. When the federal Medicaid continuous coverage requirement expires, states will redetermine eligibility for nearly all Medicaid enrollees, including roughly 1.7 million people enrolled in a Medicaid or CHIP pregnancy eligibility group. This issue brief reviews proactive strategies that states can deploy to support postpartum individuals in maintaining health coverage and access to care when the Medicaid continuous coverage guarantee ends and beyond.
The Office of the Assistant Secretary for Planning and Evaluation published a report that provides current HHS projections of the number of individuals predicted to lose Medicaid coverage at the end of the COVID-19 public health emergency (PHE) due to a change in eligibility or due to administrative churning. The report also predicts eligibility for alternative insurance coverage among those predicted to lose Medicaid eligibility and highlights legislative and administrative actions that can help minimize disruptions in coverage, including the passage of the Inflation Reduction Act, which provides enhanced Marketplace subsidies for three years that will benefit some individuals leaving Medicaid at the end of the PHE.
The Alabama Medicaid Agency will provide a COVID-19 public health emergency update for Medicaid providers and partners on September 15, 2022. Agency representatives will share how the Agency is preparing for the end of the PHE and the return to normal operations. The meeting is offered for attendees both in-person or virtual (online or by phone).
The Centers for Medicare & Medicaid Services (CMS) released a new resource highlighting the states that have obtained CMS approval for various section 1902(e)(14) waivers to support “unwinding” from the Medicaid continuous coverage requirement. Among the 20 states with approved waivers, 70 percent have obtained flexibility to (1) conduct ex-parte renewals for individuals with no income and no data returned, and (2) accept updated enrollee contact information from managed care plans. Of note, one state (Alabama) has been granted “off-menu” authority to renew Medicaid eligibility for Temporary Assistance for Needy Families participants.
Per HB 4035, the Oregon Joint Task Force on the Bridge Health Care Program was created to design a “bridge program” which could offer healthcare coverage to people leaving the Oregon Health Plan (Medicaid) at the end of the PHE. The task force recently convened to hear an update from the Oregon Health Authority (OHA) on their planning for post-public health emergency eligibility renewals.
The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources. This expert perspective has been updated as of August 5, 2022 to include reference to additional guidance released by the Centers for Medicare & Medicaid Services.
This expert perspective focuses on strengthening communications to enrollees once the federal public health emergency is lifted and the continuous enrollment requirement ends to ensure that those who are eligible maintain their coverage, and those who are ineligible are transitioned to a Marketplace plan or other insurance. The intention is to help states develop a timeline within their communications plans to coordinate and sequence outreach to these consumer groups. Critical in this effort to reduce churn will be effective coordination with stakeholders. This expert perspective outlines outreach strategies and tactics state Medicaid agencies and State-Based Marketplaces can implement to effectively inform enrollees what is happening and what actions they may need to take to stay insured.
The Arizona Health Care Cost Containment System posted a summary of its Public Health Emergency Operational Unwinding Plan to inform stakeholders of the state’s plan for reinstating regular enrollment and operational procedures when the PHE ends. The summary and full operational plan are available on the Preparing for the End of COVID-19: Return to Normal Renewals webpage along with fliers, messaging toolkits, and other resources to help communities prepare for the end of the PHE.
This session provided a brief update as part of MACPAC’s ongoing monitoring of the public health emergency (PHE). The Commission has been closely following the Centers for Medicare & Medicaid Services (CMS) and state preparations for unwinding the PHE continuous coverage requirement. In particular, the Commission is focused on the potential risk of eligible individuals inappropriately losing coverage as states resume redeterminations, as well as state administrative and system capacity to handle redeterminations.
The Department of Health Care Policy & Financing has created a toolkit to provide community partners, stakeholders, and advocates with messaging and resources to encourage Health First Colorado and Child Health Plan Plus members to update their contact information in advance of the end of the public health emergency.
This expert perspective, the second in a series about maintaining continuity of coverage and care during the public health emergency unwinding, identifies strategies for state-based Marketplaces (SBMs), in partnership with Medicaid agencies, departments of insurance, consumer assisters, and participating insurers, to help maintain continuity of care. The first expert perspective noted strategies that state Medicaid agencies can use to mitigate disruptions to coverage and care. A third expert perspective will discuss strategies for the SBMs and their partners to help ensure continuity of coverage.
The New Hampshire Department of Health and Human Services (DHHS) hosted a healthcare coverage renewal event on June 9 for Medicaid enrollees to provide updated information and receive assistance completing their applications. Individuals attending the event received a free bag of groceries and representatives were on hand to assist with applying for other public benefit programs.
On Wednesday, May 25, the Louisiana Department of Children & Family Services sent a text alert on behalf of the Louisiana Department of Health; the text was an “LADCFS Alert” asking Medicaid members to update their contact information by calling the number on their health plan card or visiting this link. LDH is conducting outreach to members in several ways to make sure their contact information is up to date.
The Arizona Health Care Cost Containment System director Jami Snyder spoke with KJZZ’s The Show about the impact of the public health emergency on Arizona’s Medicaid program and what enrollees can do to prepare for the renewal process, expected to begin later this year when the PHE ends.
The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources. This expert perspective has been updated as of August 5, 2022 to include reference to additional guidance released by the Centers for Medicare & Medicaid Services.
Improving ex parte rates as part of the Medicaid renewal process is one of the most effective tools available to states to mitigate coverage loss for eligible individuals when the public health emergency (PHE) ends. There are tremendous benefits to enrollees and to states in maximizing eligibility redetermination through an ex parte process. As states develop their unwinding policies and operational plans in readiness for the end of the PHE, improving ex parte rates should be at the top of their priority list. This toolkit contains a table that can be used by a state to examine current ex parte processes and identify and deploy additional strategies that could increase their ex parte rates.
This expert perspective, the first in a two-part series, outlines strategies state Medicaid agencies can take to identify people with high health needs and provide them with additional support to retain or transition their health coverage in order to maintain access to essential healthcare services when the current Medicaid continuous coverage requirement ends. A second expert perspective will identify complementary strategies state-based marketplaces and departments of insurance can implement to help these individuals transition without gaps in coverage or care.
The Centers for Medicare & Medicaid Services (CMS) released a new tool states can use to further prepare for the eventual end of the COVID-19 public health emergency (PHE) and return to normal Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment operations. Specifically, this tool highlights the ten fundamental actions states need to complete to prepare for unwinding when the Medicaid continuous enrollment requirement ends.
On May 17, 2022, the Department of Health Care Services (DHCS) released the Medi-Cal COVID-19 Public Health Emergency (PHE) Operational Unwinding Plan. The two primary purposes of this document are to: 1) describe DHCS’ approach to unwinding or making permanent temporarily flexibilities implemented across the Medi-Cal program during the PHE; and 2) describe DHCS’ approach to resuming normal Medi-Cal eligibility operations following the end of the PHE.
The Centers for Medicare & Medicaid Services (CMS) released a resource that reminds states of their obligation to continue to meet federal requirements related to eligibility and enrollment in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP) during the COVID-19 public health emergency unwinding period. This tool includes information for states on the requirements for eligibility renewals and redeterminations, application processing, fair hearings, coordination with the Marketplace, and other processes. Additionally, this resource highlights temporary options available to states during the unwinding period to facilitate eligibility and enrollment processing and retain coverage for eligible individuals.
As many as 16 million people are expected to lose Medicaid once the COVID-19 public health emergency and the Medicaid continuous coverage requirement end. One-third of these could be eligible for ACA marketplace plans. In a new post for the Commonwealth Fund’s To the Point blog, Sabrina Corlette and Maanasa Kona of the Georgetown Center on Health Insurance Reforms discuss strategies that marketplaces can deploy to help reduce the potential coverage loss and help consumers make a smooth transition
On April 22, 2022, CMS released a proposed rule that would create a Medicare special enrollment period (SEP) to be timed with the end of the Medicaid continuous coverage requirement. CMS is proposing the SEP for individuals enrolled in Medicaid when they initially qualify for Medicare who do not enroll in Medicare coverage when they turn 65, resulting in a coverage gap if they are then determined ineligible for Medicaid coverage following the end of the continuous coverage requirement. The proposed SEP would allow individuals to enroll after termination of Medicaid coverage following the end of the federal public health emergency (PHE) without being subject to a late enrollment penalty.
This toolkit highlights opportunities for states to leverage managed care plans to support unwinding the Medicaid continuous coverage requirement. Close collaboration between states and managed care plans will be essential to ensuring eligible individuals retain coverage in Medicaid/CHIP and easing transitions to the Marketplace. The toolkit, updated as of April 26, 2022, features guidance released by CMS for states on working with managed care plans.
The Oklahoma Health Care Authority is preparing for the end of the Public Health Emergency (PHE) by asking all SoonerCare members to update their contact information and documentation.
Louisiana Medicaid has launched a phone campaign to encourage its members to update their contact information.
The New Hampshire Department of Health and Human Services created a webpage to host information on the unwinding of the federal Medicaid continuous coverage requirement, including sample member notices.
CA DHCS created a page on the unwinding of the federal Medicaid continuous coverage requirement, promoting a coordinated, phased communications plan to reach enrollees with messages across multiple channels using trusted messengers. The page includes a link to their Medi-Cal Continuous Coverage Toolkit.
The Centers for Medicare & Medicaid Services (CMS) released a new tool for states to utilize as they prepare to return to normal eligibility and enrollment operations after the COVID-19 public health emergency. The tool provides states with a summary of best & promising practices gleaned from discussions that CMS had with Medicaid agency leadership from each state, DC and three U.S. territories. The tool includes information on strategies states are implementing related to outreach, enrollee communications, renewals, updating enrollee contact information and addressing workforce issues to support their preparation for returning to normal eligibility and enrollment operations after the COVID-19 public health emergency.
The Centers for Medicare & Medicaid Services (CMS) released a new tool for states to utilize as they prepare to return to normal eligibility and enrollment operations after the COVID-19 public health emergency. The tool provides states with strategic approaches for processing Medicaid fair hearings as states resume normal eligibility and enrollment operations. Contained in the tool are steps a state may want to take to assess their fair hearing process and capacity, strategies to address anticipated fair hearing volume, and how to request authority from CMS to implement a mitigation strategy if needed.
New state reporting templates and guidance released by the Centers for Medicare & Medicaid Services (CMS) on March 22, 2022, build upon a State Health Official letter released on March 3. The resources specify both the data and the metrics that states will be required to submit to monitor enrollment and renewal efforts as they resume routine Medicaid and CHIP operations following the end of the COVID-19 PHE. This expert perspective summarizes the new reporting requirements and presents a set of considerations for states as they begin implementing new unwinding policies, procedures, and reporting.
Once the public health emergency ends, state Medicaid agencies will need to recommence Medicaid eligibility redeterminations and renewals. As a result, up to 16 million people are projected to lose their Medicaid coverage, and an estimated one-third of these individuals will be eligible for subsidized coverage in the Affordable Care Act (ACA) Marketplaces. Whether a state’s Medicaid agency moves swiftly or slowly to process eligibility redeterminations, the commercial insurance market–and particularly the ACA Marketplaces–could experience a significant growth in enrollment. This issue brief identifies several areas in which state departments of insurance (DOIs) may want to coordinate with other agencies or external stakeholders, issue new regulations or guidance, and establish means for minimizing gaps in coverage or access to services.
The Centers for Medicare & Medicaid Services (CMS) released additional templates and resources to support state reporting around enrollment and renewal efforts when the federal public health emergency (PHE) concludes. The resources include 1) a “Renewal Distribution Report” form in which states will be required to summarize their renewal plans, with a focus on mitigating inappropriate coverage loss during the unwinding period and 2) an “Unwinding Eligibility and Enrollment Data Reporting” Excel workbook and specifications document, which aims to support states in reporting on certain metrics around timely application processing, renewal initiation and completion, reason for termination, and fair hearings. CMS also previewed that states will eventually report on these metrics on a monthly basis.
A report from the Kaiser Family Foundation and Georgetown University Center for Children and Families presents a snapshot of actions states are taking to prepare for the lifting of the continuous enrollment requirement, as well as key state Medicaid enrollment and renewal procedures in place during the PHE.
A new Urban Institute issue brief, co-authored by researchers from Georgetown University, examines preparations for the end of the PHE in 11 states with SBMs. The brief identifies major challenges state officials are facing and best practices for keeping people in coverage that could be adopted by the federally facilitated Marketplace and SBMs.
A new Urban Institute report includes updated projections of Medicaid coverage and costs following the end of the public health emergency (PHE). The report builds upon a previous analysis on the rise in Medicaid enrollment at the start of the COVID-19 pandemic, mainly attributable to the continuous coverage requirement of the Families First Coronavirus Response Act. In their new brief, Urban projects Medicaid enrollment for the population under age 65 and federal and state Medicaid spending for 2022 and 2023, assuming the PHE is extended through the first, second, or third quarters of 2022. The authors find that the longer the PHE lasts, the greater the potential number of people losing Medicaid coverage over the 14 months after the PHE ends: 12.9 million if it expires after the first quarter of 2022, 14.4 million if it expires after the second quarter, and 15.8 million if it expires after the third quarter.
On March 3, the Centers for Medicare & Medicaid Services (CMS) released a State Health Official (SHO) letter, “Promoting Continuity of Coverage and Distributing Eligibility and Enrollment Workload in Medicaid, the Children’s Health Insurance Program (CHIP), and Basic Health Program (BHP) Upon Conclusion of the COVID-19 Public Health Emergency.” This expert perspective summarizes the highly anticipated guidance, which clarifies CMS expectations for state Medicaid and CHIP agencies as they prepare to process outstanding eligibility and enrollment actions when the federal Medicaid continuous coverage requirement ends.
CMS released a State Health Official letter outlining guidance to ensure states are well-prepared to initiate eligibility renewals for all individuals enrolled in Medicaid and CHIP within 12 months of the eventual end of the PHE and to complete renewals within 14 months. The new guidance provides reporting tools as well as an eligibility and enrollment tool.
Medicaid agencies are required to send written notices to enrollees as they begin their redetermination process after the continuous coverage requirement ends. This document contains template notices designed for use by state Medicaid agencies in their efforts to communicate with enrollees. State Medicaid agencies can customize these documents by editing them to input their state seal or agency logo and other state-specific information. These notices incorporate recommendations from the Centers for Medicare & Medicaid Services and reflect insights from qualitative testing with Medicaid enrollees during focus groups in February 2022.
When the Families First Coronavirus Response Act Medicaid “continuous coverage” requirement is discontinued states will restart eligibility redeterminations, and millions of Medicaid enrollees will be at risk of losing their coverage. A lack of publicly available data on Medicaid enrollment, renewal, and disenrollment makes it difficult to understand exactly who is losing Medicaid coverage and for what reasons. Publishing timely data in an easy-to-digest, visually appealing way would help improve the transparency, accountability, and equity of the Medicaid program. This expert perspective lays out a set of priority measures that states can incorporate over time into a data dashboard to track Medicaid enrollment following the end of the continuous coverage requirement. For a detailed discussion of the current status of Medicaid enrollment and retention data collection and best practices when developing a data dashboard to display this type of information, SHVS has published a companion issue brief.
As state Medicaid and Children’s Health Insurance Program (CHIP) agencies develop their strategies for unwinding the federal Medicaid continuous coverage requirement under the Families First Coronavirus Response Act, many are looking to text messaging as a mechanism for outreach to their Medicaid and CHIP enrollees and communicating important information. This expert perspective describes states’ authority to send text messages and requirements for obtaining consent. The expert perspective also contains sample consent language to include in the Medicaid/CHIP application as well as template text messages.
The Families First Coronavirus Response Act (FFCRA) Medicaid “continuous coverage” requirement has allowed people to retain Medicaid coverage and get needed care during the COVID-19 pandemic. When continuous enrollment is discontinued, states will restart eligibility redeterminations, and millions of Medicaid enrollees will be at risk of losing their coverage. The current lack of publicly available and timely Medicaid enrollment, renewal, and disenrollment data will make it difficult to understand exactly who is losing coverage and for what reasons. One effective way to monitor this type of information is through the use of Medicaid enrollment and retention dashboards. This issue brief examines the current status of data collection to assess Medicaid enrollment and retention, summarizes potential forthcoming reporting requirements, and describes some of the best practices states should consider when developing a data dashboard to display this type of information. The issue brief lays out a phased set of priority measures and provides a model enrollment and retention dashboard template.
On November 24, CMS released a “punch list” of strategies states and the US territories can adopt to maintain coverage of eligible individuals as they return to normal operations after the end of the public health emergency. The strategies are organized around seven topics areas: (1) strengthening renewal processes; (2) updating mailing addresses; (3) improving consumer outreach, communication, and assistance; (4) promoting seamless coverage transitions; (5) improving coverage retention; (6) addressing strains on the eligibility and enrollment workforce; and (7) enhancing oversight of eligibility and enrollment operations. In this resource, CMS also flagged strategies they expect to have the biggest impact on mitigating coverage losses.
On Wednesday, November 10 State Health and Value Strategies hosted a webinar that provided an overview of strategies for states seeking to ensure that eligible enrollees are able to keep or transition to new affordable health coverage when the Medicaid continuous coverage requirement ends. States will be resuming eligibility and enrollment activities for all enrollees in Medicaid and the Children’s Health Insurance Program (CHIP), and as part of their planning, states have an opportunity to retain coverage gains experienced over the pandemic period by taking steps to ensure that eligible enrollees are able to keep Medicaid/CHIP coverage, and those who are eligible for subsidized Marketplace coverage are transitioned and enrolled. Experts from Manatt Health and McKinsey & Company discussed how states can prepare now by deploying strategies to update enrollee contact information, and make other eligibility and enrollment technology changes to better serve their residents.
Following the expiration of the Public Health Emergency (PHE), states will resume normal eligibility and enrollment activities for all enrollees in Medicaid and the Children’s Health Insurance Program (CHIP). The volume of expected redetermination activity at the end of the PHE is unprecedented. This issue brief reviews state Medicaid/CHIP agency data and information technology (IT) system “table stakes”—strategies that will have the highest impact for states seeking to ensure that eligible enrollees are able to keep or transition to new affordable health coverage when the PHE continuous coverage requirements end. If adopted, these strategies will also enable states to dramatically improve Medicaid/CHIP enrollment and coverage retention in the longer-term for people eligible for government subsidized health coverage.
At the end of the public health emergency (PHE), people currently enrolled in Medicaid and the Children’s Health Insurance Program are at risk of losing their coverage unless state Medicaid/CHIP agencies take steps to update enrollee mailing addresses and other contact information. This expert perspective examines the information technology system, policy, and operational strategies states can consider to update key enrollee contact information to ensure eligible enrollees are able to keep or transition to new affordable health coverage at the end of the PHE.
On Wednesday, April 29 State Health and Value Strategies hosted a webinar, State Strategies to Support Medicaid/CHIP Eligibility and Enrollment in Response to COVID-19. Many states are experiencing an increase in the volume of Medicaid applications due to the COVID-19 pandemic and the resulting economic crisis. It is important for states to understand the policy and operational strategies they can use to ensure that people who are eligible for the Medicaid program can apply, enroll and start receiving benefits as quickly as possible. During the webinar experts from Manatt Health reviewed strategies states can use to manage and process an increased number of Medicaid applications, and the federal authorities that permit states to do so. Communications experts from GMMB reviewed strategies for messaging to new and existing enrollees. As a companion to this webinar, SHVS has also published a Medicaid COVID-19 Messaging toolkit.
As a condition of receiving enhanced federal funding under the Families First Coronavirus Response Act (FFCRA), states are prohibited from terminating individuals enrolled in Medicaid as of March 18, 2020, or determined eligible on or after that date. These continuous coverage requirements run through the end of the month of the public health emergency (PHE), which was recently extended to October 22, 2020. Absent a further extension of the PHE, states have three months to implement a plan for unwinding the FCCRA continuous coverage requirements which are otherwise set to terminate on October 31, 2020. States will also need to identify which newly obtained eligibility and enrollment flexibilities they would like to make permanent beyond the termination of the PHE–especially in the context of emerging information that suggests that the duration of COVID-19 pandemic may extend well into 2021.
On Thursday, January 21 State Health and Value Strategies hosted a webinar on the long-awaited guidance to state Medicaid and CHIP agencies on resuming normal operations following the end of the COVID-19 public health emergency. During the webinar experts from Manatt Health discussed the sub-regulatory guidance and the implications for states, in light of the recent public health emergency renewal by Secretary Azar. The webinar reviewed the expectations laid out in the guidance related to timelines, consumer communications, and fair hearing processes for redetermining Medicaid eligibility for those who have had their coverage continuously maintained as a condition of receiving the temporary 6.2 percent FMAP increase under the Families First Coronavirus Response Act. Additionally, presenters discussed the expected processes and timelines for terminating, or making permanent where allowable, temporary federal flexibilities that were obtained.
On January 6, 2021, CMS released an updated FAQ document that incorporates all eight sets of COVID-19 FAQs into one, comprehensive FAQ document.
CMS Expanding Coverage Under Medicaid and CHIP: Materials developed by the Expanding Coverage MAC Learning Collaborative for states.
Following unprecedented Medicaid enrollment during the public health emergency, analysis projects that 15 million people could lose Medicaid coverage when the emergency declaration ends.
With support from the Robert Wood Johnson Foundation, Benefits Data Trust (BDT) has developed this “Medicaid Churn Toolkit” to guide Medicaid agencies and their partners in the design and implementation of efforts to reduce churn as they plan for the resumption of normal eligibility and enrollment actions (including renewals, redeterminations, and post-enrollment verifications) and beyond.
On December 22, 2020, the Centers for Medicare and Medicaid Services released long-awaited guidance to state Medicaid and CHIP agencies on resuming normal operations following the end of the COVID-19 public health emergency. This issue brief provides a high-level summary of the CMS guidance related to: (1) conducting redeterminations for Medicaid enrollees who were continuously enrolled; (2) terminating, or extending where appropriate, temporary flexibilities; and (3) developing a consumer and provider communication strategy.