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.
Navigators and In-Person Assistors: State Policy and Program Design Considerations
State Health Reform Assistance Network – Shelly Ten Napel and Daniel Eckel
This brief, prepared by State Network staff, outlines important policy issues for states to consider while implementing their Navigator and In-Person Assistor (IPA) programs as well as summarizes the basic information and guidance released to date. The brief concludes with a compilation of resources, program structures, and ideas from leading State Network states. The Affordable Care Act (ACA) and related guidance have established Navigators and IPAs to help individuals enroll in Health Benefit Exchanges (Exchanges). Regardless of the type of Exchange, every state will have Navigator and In-Person Assistor programs and several states have begun to make policy and operational decisions that could be informative to other states.
This brief, part of a developing series of reports related to consumer assistance, reflects an effort to curate the growing number and depth of resources available to state policymakers on this topic. Wakely Consulting Group has produced a brief, What Should Exchanges Know about Call Centers: A Guide for Implementation, which offers states strategies and best practices for call center management. For a high level overview of consumer assistance see the brief prepared by the National Academy for State Health Policy.