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.
Building On a Solid Foundation: Leveraging Current Programs and Infrastructure in Navigator Program Development
National Academy for State Health Policy – Rachel Dolan, Christina Miller, Kimm Mooney, and Anne Gauthier
The Patient Protection and Affordable Care Act (ACA) establishes health benefits exchanges and requires them to create a navigator program to assist consumers and small businesses as they apply for and enroll in coverage. This report, prepared by the National Academy for State Health Policy, highlights the progress of six states on their initial navigator program development. Also included are potential lessons from these states’ planning efforts. The brief also gives an overview of key design considerations, lessons on incorporating current state programs, and avenues for next steps.