| Jan 18, 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 has allowed people to retain Medicaid coverage and get needed care during the pandemic. Congress passed the Consolidated Appropriations Act (CCA) on December 23, 2023, an omnibus funding package that separates the continuous coverage provision from the COVID-19 public health emergency by providing a fixed end date of March 31, 2023. The CCA 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. When states 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. These resources are designed to support states planning for this major coverage event, including developing processes that prioritize coverage retention.

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

February 3, 2023

New CMS Guidance on Unwinding Provisions in the CAA, 2023

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.

February 1, 2023

CMS Approves First-in-Nation Justice-Involved Re-Entry Section 1115 Demonstration

On January 26, 2023, the Centers for Medicare & Medicaid Services approved California’s request to amend the California Advancing and Innovating Medi-Cal Section 1115 demonstration. This expert perspective describes the amendment, a centerpiece of which is approval for California Medicaid to provide a targeted set of Medicaid services to youth and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release. By providing re-entry services to Medicaid-enrolled individuals who are incarcerated, California aims to build a bridge to community-based care for justice-involved enrollees, offering them services to stabilize their physical and behavioral health conditions and establishing, prior to release, a re-entry plan for their community-based care.

January 27, 2023

Federal Ruling Provides Text Messaging Flexibility to Support State’s Unwinding Efforts

On January 23, 2023, the Federal Communications Commission issued an important ruling that provides states with new flexibility to support enrollee outreach and communication efforts as part of their processes to unwind the Medicaid continuous coverage requirement. The ruling permits state agencies and their partners to send text messages and make phone calls to individuals about enrollment-related issues not only for Medicaid but for other state-run health insurance programs, including marketplace coverage. This expert perspective reviews the ruling and implications for states.