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.
Federally-Facilitated Exchanges and the Continuum of State Options
Manatt Health Solutions – Deborah Bachrach and Patricia Boozang
The Affordable Care Act allows states to create their own state-based health insurance exchanges or to allow a federally facilitated exchange to operate in the state. Proposed rules from the Department of Health and Human Services (HHS) also allow a partnership model where the federal and state governments share in the execution of exchange functions. This brief, supported by the State Network and published by the National Academy for Social Insurance, explores the continuum of options for states from fully state-based to fully federally facilitated, evaluating the considerations and implications associated with each option to help states determine which model may work best for the unique needs of their residents. The authors conclude that regardless of the model chosen, success can only be achieved through intensive collaboration between individual states and HHS.