| Nov 1, 2021

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” when the Medicaid continuous coverage requirement ends. The Families First Coronavirus Response Act (FFCRA) Medicaid “continuous coverage” requirement has allowed people to retain Medicaid coverage and get needed care during the pandemic. When continuous enrollment is discontinued, states will restart eligibility redeterminations for Medicaid enrollees. 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. This resource is designed to support states planning for this major coverage event, including developing processes that prioritize coverage retention following the conclusion of the continuous coverage requirement.

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 public health emergency

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

June 16, 2022

Leveraging Section 1902(e)(14) Waiver Authority Amid Unwinding

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.

June 15, 2022

Using Marketplace Retroactive Coverage to Facilitate Continuous Enrollment in the Public Health Emergency Unwinding

Providing a retroactive coverage option in the Marketplace is one innovative strategy for eliminating coverage gaps between Medicaid and Marketplace coverage for people eligible to make that transition at the end of the public health emergency. Pennsylvania’s state-based Marketplace, Pennie, is considering an optional retroactive coverage policy. This expert perspective describes the retroactive coverage policy innovation and its benefits, and offers strategies for states to consider in their implementation that will maximize coverage continuity, minimize adverse selection, and address potential operational challenges.