The End of the Public Health Emergency Will Prompt Massive Transitions in Health Insurance Coverage: How State Insurance Regulators Can Prepare
Once the public health emergency ends, state Medicaid agencies will need to recommence Medicaid eligibility redeterminations and renewals. As a result, up to 16 million people are projected to lose their Medicaid coverage, and an estimated one-third of these individuals will be eligible for subsidized coverage in the Affordable Care Act (ACA) Marketplaces. Whether a state’s Medicaid agency moves swiftly or slowly to process eligibility redeterminations, the commercial insurance market–and particularly the ACA Marketplaces–could experience a significant growth in enrollment. This issue brief identifies several areas in which state departments of insurance (DOIs) may want to coordinate with other agencies or external stakeholders, issue new regulations or guidance, and establish means for minimizing gaps in coverage or access to services.
On February 17, the Department of Homeland Security (DHS) released its 2022 notice of proposed rulemaking (NPRM) which would largely codify longstanding federal guidance regarding DHS’ authority to refuse a noncitizen’s application for admission or application for visa adjustment (including receipt of a green card) on grounds that they are “likely at any time to become a public charge.” This issue brief provides an overview of key provisions of the 2022 NPRM and includes commentary to describe how the proposed rule differs from the 1999 Field Guidance, as well as how the proposed rule seeks to promote clarity and address the chilling effects caused by elements of the now-repealed 2019 Rule.
On Wednesday, October 6 State Health and Value Strategies hosted a webinar that provided an overview of eligibility standards for evacuees and strategies that states can deploy to expeditiously enroll people into health coverage in order to access care. Tens of thousands of Afghans who fled the Taliban are awaiting resettlement, with many having already arrived in the U.S. living on military bases and being processed in several states. During the webinar, experts from Manatt Health reviewed CMS guidance that was released on September 27, 2021 to help states understand what health coverage options are available to Afghan evacuees.
The slide deck has been updated as of March 16, 2022 to reflect an updated factsheet CMS released on November 1, 2021 as well as the latest information on the number of states resettling Afghan nationals.
State Health and Value Strategies has created a flyer for states to customize to share information regarding health coverage with Afghan evacuees recently re-settled or in the process of being re-settled in their state. The flyer has been translated into commonly used Afghan languages of Dari and Pashto. The flyer has been updated as of March 16, 2022 to align with an updated CMS factsheet.
The Tracking Medicaid Enrollment Growth During COVID-19 Databook provides a comprehensive, detailed look at Medicaid enrollment trends to-date. Using Medicaid enrollment data from over 40 states, the Databook provides a comprehensive, detailed look at Medicaid enrollment trends from the beginning of the COVID-19 pandemic through November 2021. The Databook provides enrollment detail by state across four eligibility categories: expansion adults, children (including those enrolled in CHIP), non-expansion adults, and aged, blind, and disabled individuals. It also compares enrollment trends across expansion and non-expansion states. The latest version of the Databook (as of March 2022) has been updated through November 2021.
Reshaping the Narrative on Public Charge to Reach Immigrant Populations That Need Affordable Health Insurance
Many immigrants and their families are concerned that enrolling in Medicaid/CHIP, Marketplace, and other public health insurance programs will run afoul of public charge rules and jeopardize their immigration status. These fears remain despite the fact that the administration has reinstated longstanding public charge guidance that does not consider the use of Medicaid/CHIP benefits (other than government-funded institutionalization for long-term care) or Marketplace coverage in a public charge determination. This issue brief, the third in a series, Supporting Health Equity and Affordable Health Coverage for Immigrant Populations, provides an overview of the status of the public charge rule and presents strategies to help connect eligible individuals to affordable coverage.
Password protected resource page for members of the Strategies for Improving Collection of RELD Data affinity group.
Medicaid agencies are required to send written notices to enrollees as they begin their redetermination process after the continuous coverage requirement ends. This document contains both English and Spanish template notices designed for use by state Medicaid agencies in their efforts to communicate with enrollees. State Medicaid agencies can customize these documents by editing them to input their state seal or agency logo and other state-specific information. These notices incorporate recommendations from the Centers for Medicare & Medicaid Services and reflect insights from qualitative testing with Medicaid enrollees during focus groups in February 2022.
On Tuesday, February 15, State Health and Value Strategies hosted a webinar, Centering Health Equity in Medicaid Section 1115 Demonstrations. Many states are looking to Medicaid as a critical lever for advancing health equity, and states have multiple tools and authorities in Medicaid to advance health equity through coverage and benefit policy, delivery system and payment reform, and innovations that impact social drivers of health. During the webinar experts from Manatt Health provided an overview of Medicaid’s role in promoting health equity and ways states can advance health equity and address structural racism throughout the Section 1115 demonstration lifecycle, from planning to implementation to monitoring, and evaluation.
A recognition by leaders and policymakers in many states that longstanding structural racism has caused disproportionate health risks and poorer health outcomes for communities of color is prompting action to prioritize and advance health equity. One key strategy states are using to test new or innovative ideas related to health equity in their Medicaid programs is Section 1115 demonstrations. A new series from State Health and Value Strategies shares strategies for states to consider as they work to advance health equity and address structural racism through Medicaid Section 1115 demonstrations.