On January 27, 2023, the Centers for Medicare & Medicaid Services 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.” The 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. This expert perspective reviews the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage as laid out in the SHO letter.
Making Medicaid Estate Recovery Policies More Equitable: State Toolkit
Anne Karl and Luis Bourgeois, Manatt Health
Medicaid estate recovery has important health equity implications. While estate recovery is intended to recoup funds to support the Medicaid program and ensure that enrollees and their families who are able to pay for long-term services and supports do so, the burden falls disproportionately on families of color and exacerbates existing inequities in the distribution of wealth tied to the historical and contemporary realities of structural discrimination and racism. This toolkit is intended to assist state officials in evaluating their current estate recovery policies and understanding where they may have flexibility to make the policies less burdensome for affected low-income families.