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.
State Considerations for Medicaid Buy-In Proposals
Lawmakers across the country are considering Medicaid buy-in or “public option” programs to stabilize the Affordable Care Act (ACA) insurance market and offer a coverage option that is more affordable and accessible than current options in the individual and employer markets. So far in the 2019 legislative session, more than 10 states have introduced legislation to study or implement a buy-in.1 A new State Health and Value Strategies issue brief, State Medicaid Buy-Ins: Key Questions to Consider, explores the key questions that states will want to consider as they pursue design, and implementation of buy-in proposals. This State Health Policy Highlight provides a checklist summarizing the key questions, which are laid out in greater detail in the underlying issue brief.