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.
Changes in Coverage: Managing the Loss of ESI in the Midst of COVID-19
On Thursday, May 14, State Health and Value Strategies, in partnership with technical experts from Manatt Health, Levitis Strategies, GMMB, and the Urban Institute hosted a webinar for states to help address the rapidly-evolving changes to the coverage environment. As the COVID-19 crisis evolves, it has become clear that rising unemployment will substantially reduce employer sponsored health insurance. Depending on how Congress responds, there are likely to be significant increases in Medicaid and Marketplace coverage, as well as more people uninsured. These coverage churns will leave states grappling to understand and implement timely and effective strategies to ensure individuals have access to, and enroll in coverage, that is most appropriate for their situation.
During the webinar, speakers discussed the models that have been published of where individuals are expected to gain coverage over the next 18 months, including data from a recent Urban Institute report, the impact on the Medicaid, individual, and employer-sponsored insurance markets, the role of special enrollment periods, and coordination with unemployment agencies. The webinar also highlighted communications opportunities and strategies for states to support enrollment.