State updates as of September 29, 2023.

This expert perspective provides a high-level overview of key provisions included in the “Streamlining Medicaid; Medicare Savings Program Eligibility Determination and Enrollment” final rule that will facilitate enrollment and retention of Medicare Savings Program (MSP) coverage. MSPs are state-run programs that help low-income Medicare enrollees pay their Medicare premiums and/or cost-sharing. While the final rule’s effective date is November 17, 2023, CMS delayed compliance dates for most provisions until April 1, 2026, to reflect states’ competing priorities in light of the “unwinding” of the Medicaid continuous coverage requirement.

As congressional negotiations continue to stall on fiscal year 2024 appropriations, federal agencies are deep into contingency planning for a potential government shutdown beginning October 1. Decisions are still being made about which federal activities and personnel are considered essential. This expert perspective describes the plans currently available from the Department of Health and Human Services and the implications for health programs and personnel.