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.
Designing Consumer Assistance Programs: Resources from the Field
National Academy for State Health Policy – Katie Baudouin, Christina Miller, and Rachel Dolan
This issue brief, prepared by the National Academy for State Health Policy (NASHP), outlines major state decisions regarding coverage expansion consumer assistance strategies and lists valuable tools that state officials can use when determining how to meet the needs of new and existing consumers. The appendix includes links to resources that can help state officials design consumer assistance programs. The brief covers four major methods states are considering to provide consumer assistance:
– Outreach and engagement through marketing and advertising;
– Enrollment assistance through navigators and in-person assistors;
– Engagement of insurance producers (inclusive of both agents and brokers); and,
– Individualized support through call centers and other communications.
The State Network also released two additional consumer assistance focused briefs. Wakely Consulting Group’s brief, What Should Exchanges Know about Call Centers: A Guide for Implementation,offers states strategies and best practices for Call Center management. Navigators and In-Person Assistors: State Policy and Program Design Considerations, is a brief produced by State Networkstaff that outlines Navigator roles and provides a resource list for state officials.