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.
California enacted Senate Bill 260 in 2019, instructing Covered California, the state’s official health insurance Marketplace, to automatically enroll eligible individuals transitioning off Medi-Cal in a subsidized Marketplace plan, while allowing them to opt out or choose a different plan. Launched in May 2023, the program facilitated the enrollment of 112,000 Medi-Cal transitioners by March 2024. In a report published by the California Health Care Foundation, researchers from Georgetown University examine the key policy and operational decisions California made to implement Senate Bill 260, the early results, and considerations for other states interested in establishing similar facilitated enrollment programs.
The Colorado Division of Insurance has extended the enrollment window for people who are no longer eligible for Medicaid coverage due to unwinding. The deadline is now November 30, 2024 to enroll in health insurance through the Marketplace, extended from the previous deadline of July 31.
Covered California, the state’s official health insurance Marketplace, announced that more than 158,000 Californians remained covered through the Medi-Cal to Covered California enrollment program over the past year during unwinding of the Medicaid continuous coverage requirement. Under the program, Covered California automatically enrolls individuals in one of its low-cost health plans when they lose Medi-Cal coverage and gain eligibility for financial help through Covered California.
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.
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 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.
Covered California, the state’s official health insurance Marketplace, launched a virtual media tour to spread the word about the upcoming Medi-Cal to Covered California enrollment program and how to keep Californians covered. A new, multilingual ad campaign was also launched to educate consumers and make sure they understand how they can stay insured. The campaign highlights how Covered California will help consumers through every step of their transition, and provide quality coverage, at low or no cost for many.
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.
As a result of the Medicaid renewal process, which resumed in April 2023, it is expected that millions of people across the country will lose Medicaid and in some cases, CHIP coverage. This presents State-Based Marketplaces (SBMs) with an opportunity to target outreach efforts to those audiences who have recently lost Medicaid or CHIP to help eligible individuals retain access to affordable healthcare through the Marketplace. This new expert perspective focuses on best practices for timing and strategy in consumer outreach to consumers that are no longer eligible for Medicaid to help states develop a consumer “chase campaign”.
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.
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.
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.
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 impending end of the federal public health emergency (PHE) will be one of the most significant health coverage events since the implementation of the Affordable Care Act, as state Medicaid agencies across the country will resume regular renewal processes for over 89 million people. The resumption of redeterminations means that many Medicaid enrollees will need to affirmatively renew their coverage and those who are no longer eligible for Medicaid will need to transition to other forms of coverage or go uninsured. To help states effectively communicate with enrollees, this expert perspective provides research-based recommendations regarding terminology that can be used in consumer education and outreach.
This page provides communications resources designed to support states as they prepare for the various stages of work needed to inform stakeholders and consumers about the upcoming end of the Medicaid continuous coverage requirement. The end of the Medicaid continuous coverage requirement presents states with tremendous opportunities to keep individuals enrolled in Medicaid or transition to another form of health coverage.
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.
Kristen Challacombe, Deputy Director of Business Operations, appeared on the latest episode of “AHCCCS Explains” (a video series about the state’s Medicaid program) to explain what AHCCCS members can do to prepare for the end of the public health emergency.
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.
The Department of Health Care Services released a request for information (RFI) seeking an experienced communications/advertising vendor to implement a broad and targeted education and outreach communications campaign for Medi-Cal (Medicaid) enrollees during and after the end of the COVID-19 PHE. Responses to the RFI are due by August 19, 2022.
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.
CMS posted an FAQ that says issuers that reduce or eliminate agent and broker commissions for enrollments through special enrollment periods (SEPs) are violating the guaranteed issue provisions of the ACA and doing so would constitute a discriminatory marketing practice.
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.
Providing a retroactive coverage option in the Marketplace is one innovative strategy for eliminating coverage gaps between Medicaid and Marketplace coverage for people eligible to make that transition at the end of the public health emergency. Pennsylvania’s state-based Marketplace, Pennie, is considering an optional retroactive coverage policy. This expert perspective describes the retroactive coverage policy innovation and its benefits, and offers strategies for states to consider in their implementation that will maximize coverage continuity, minimize adverse selection, and address potential operational challenges.
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.
A recently published Kaiser Family Foundation issue brief projects Medicaid enrollment growth through the end of fiscal year 2022. The brief examines how much of the enrollment growth can be attributed to baseline, or expected enrollment increases without the pandemic, and how much can be attributed to the continuous coverage requirement during the PHE. The brief explores the costs tied to PHE-related enrollment growth, estimates how much fiscal relief was provided to states through the enhanced federal Medicaid match rate (FMAP), and describes scenarios for enrollment going forward. The issue brief estimates that the fiscal relief from the enhanced FMAP will exceed the costs of the additional enrollment in every state, though the degree to which that is the case varies by state.
HHS Secretary Becerra and CMS Administrator Brooks-LaSure sent a letter to governors discussing the flexibilities made available to states to support the unwinding of the continuous coverage requirement. The letter also includes a list of resources that HHS has issued to assist states with redeterminations, and reminds states that they should be putting in place processes to ensure coverage for Medicaid enrollees when the PHE ends.
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 May 3, 2022, the Federal Communications Commission (FCC) opened a public comment period for feedback on a letter submitted by the Department of Health and Human Services Secretary Xavier Becerra and Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure. The letter requests the FCC’s opinion on the use of text messages and automated calls to enrollees as states resume regular operations at the end of the COVID-19 Public Health Emergency. This expert perspective provides model comments to inform and support state responses to the FCC’s public comment period.
The state’s Office of Superintendent of Insurance recently notified its carriers that a broker compensation structure that pays differing commissions for open and special enrollments violates state nondiscrimination provisions and constitutes an unfair or deceptive practice under the state’s unfair trade practices statute.
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.
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 Virginia Department of Medical Assistance Services created an unwinding toolkit for healthcare plans, stakeholders, and government agency partners on preparing for the end of the public health emergency. The toolkit contains information and resources to guide stakeholders and advocates as they assist Medicaid members with the end of the public health emergency.
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.
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.
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.
Medicaid enrollment has increased by over 10 million (or 15 percent) from February 2020 through February 2021 across all states since the outbreak of the COVID-19 pandemic. States have a clear imperative to center health equity as they plan for the end of the public health emergency (PHE) given that Black, Latino/a, and other people of color are most at risk of coverage loss. This expert perspective highlights strategies states can implement to ensure that the end of the PHE does not exacerbate already widespread racial and ethnic disparities in our health care system.
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.