| May 5, 2023

Resources for States on Unwinding the Medicaid Continuous Coverage Requirement

State Health and Value Strategies (SHVS) developed this resource page to serve as an accessible one-stop source of information for states in “unwinding” the Medicaid continuous coverage requirement. The Families First Coronavirus Response Act (FFCRA) Medicaid continuous coverage requirement allowed people to retain Medicaid coverage and get needed care during the pandemic. On December 29, 2022, President Biden signed into law the Consolidated Appropriations Act, 2023 (CAA), an omnibus funding package that decoupled the continuous coverage provision from the end of the COVID-19 public health emergency by providing a fixed end date of March 31, 2023. The CAA also includes a gradual phase down of the enhanced federal match rate and new guardrails to prioritize coverage retention and smooth coverage transitions during the unwinding.

While most people will continue to be eligible for Medicaid or Marketplace coverage, the potential for loss of coverage for millions of Americans due to “administrative” reasons is significant, and Black, Latino(a) and other people of color will be most at risk. These resources are designed to support states during this major coverage event, including developing processes that prioritize coverage retention.

As states operationalize unwinding, SHVS is tracking the work states are engaged in through the series States of Unwinding which aims to showcase strategies that other states may be interested in adopting and highlight how states are leveraging federal flexibilities.

SHVS will update this page frequently with new resources as they become available.

SHVS Resources and Tools

SHVS technical assistance resources on the unwinding of the Medicaid continuous coverage requirement

Please click on the links below to access topic-specific resources.

Health Equity
Data/IT Eligibility and Enrollment Policy/Operations Consumer Communications and Outreach
Oversight and Monitoring Medicaid and Marketplace Integration Federal Resources

 

 

Expert Perspectives

December 1, 2023

The Proposed 2025 Notice of Benefit and Payment Parameters: Implications for States

On November 15, 2023, the Centers for Medicare & Medicaid Services released its proposed 2025 Notice of Benefit and Payment Parameters, the annual regulation which governs core provisions of the Affordable Care Act. This expert perspective focuses on aspects of the proposed rule likely to be of interest to state officials, including requirements for State-Based Marketplaces to align with the standards of the Federally Facilitated Marketplace, proposals for states to update essential health benefits, and initiatives to ease the eligibility and enrollment process for consumers.

CMS Releases Information Bulletin on Coverage of Services and Supports to Address Health-Related Social Needs in Medicaid

This expert perspective summarizes CMS’ new Informational Bulletin and accompanying framework which together detail Medicaid coverage options for services that address the health-related social needs (HRSN) of Medicaid enrollees. The new guidance reiterates the importance of addressing HRSNs to improve access to care and health outcomes, and summarizes (and in some cases updates) multiple previous sources of CMS guidance on how HRSN services may be covered in Medicaid, including guidance on in lieu of services authority and on HRSN coverage in section 1115 waivers.