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.
Medicaid and CHIP Coverage of COVID-19 Vaccine and Treatment: A Roadmap for State Action During and After the Public Health Emergency
Julian Polaris, Manatt Health
Since the early days of the COVID-19 pandemic, the federal government has required states to cover COVID-19 vaccines and treatments for certain eligibility groups under Medicaid and CHIP. Congress significantly enhanced those coverage requirements with the American Rescue Plan Act (ARP) of 2021. This toolkit provides a roadmap for states to identify the types of Medicaid and CHIP policy changes that may be needed to ensure compliance with ARP’s requirements for coverage of COVID-19 vaccines and treatment. It has been updated to reflect the May 5, 2021 version of CMS’s Medicaid COVID-19 Vaccine Toolkit.