On August 7, the U.S. Senate passed the Inflation Reduction Act (IRA), a $740 billion reconciliation package. The U.S. House of Representatives is expected to vote on the bill by August 12. This expert perspective describes the healthcare provisions included in the IRA, such as provisions to improve the affordability of healthcare for Medicare and Affordable Care Act (ACA) Marketplace enrollees. The expert perspective also describes several significant healthcare policies included in the House-passed Build Back Better Act that were left out of the Senate package.

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. This expert perspective has been updated as of August 5, 2022 to include reference to additional guidance released by the Centers for Medicare & Medicaid Services. 

State updates as of August 5, 2022.