Medicaid and CHIP Coverage of COVID-10 Vaccine and Treatment: A Roadmap for State Action During and After the Public Health Emergency
Since the early days of the COVID-19 pandemic, the federal government has required states to cover COVID-19 vaccines and treatments for certain eligibility groups under Medicaid and CHIP. Congress significantly enhanced those coverage requirements with the American Rescue Plan Act (ARP) of 2021. This toolkit provides a roadmap for states to assess and, if necessary, amend their Medicaid and CHIP policies to ensure compliance with ARP’s requirements for coverage of COVID-19 vaccines and treatment.
Federal Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts Effective and End Dates
To help states respond to the ongoing coronavirus (COVID-19) pandemic, the White House, the U.S. Department of Health and Human Services, and the Centers for Medicare and Medicaid Services have invoked their emergency powers to authorize temporary flexibilities in Medicaid and the Children’s Health Insurance Program. Congress’s legislative relief packages have provided additional federal support for state Medicaid programs, subject to certain conditions. The timeframes for these emergency measures are summarized in the chart, including the effective dates and expiration timelines dictated by law or agency guidance. The chart also includes current end dates, which are subject to change as federal and state officials take actions to renew or terminate particular authorities.
The American Rescue Plan Act of 2021 (ARP) establishes a new state option to extend Medicaid and CHIP coverage for pregnant women for one year following the baby’s birth. ARP’s new state option to extend continuous coverage for one-year postpartum enables states to take a major step towards improving health outcomes for postpartum women and their babies. This issue brief reviews the policy and operational considerations for states who are considering extending postpartum coverage.
Assessing the Fiscal Impact of Medicaid Expansion Following the Enactment of the American Rescue Plan Act of 2021
A substantial body of evidence indicates that adopting the Medicaid expansion delivers myriad benefits to states and Medicaid enrollees at a modest cost to states. Currently, 12 states have not yet taken up the ACA Medicaid expansion, leaving approximately 2.2 million adults in the so-called “coverage gap” without an affordable source of coverage. The recent enactment of the American Rescue Plan Act of 2021 (ARP) makes the fiscal case for Medicaid expansion even stronger by providing states that implement expansion after the enactment of ARP with a significant increase in Medicaid funding. This issue brief describes the ARP matching rate provision and also assesses its fiscal impact for each of the states that have not yet expanded Medicaid, while comparing the available new federal dollars to the cost of expansion.
The American Rescue Plan Act includes a number of provisions that will significantly impact state and federal health care policies and programs, including enhanced federal funding for state Medicaid spending on home- and community-based services (HCBS). Beginning April 1, 2021 and through March 31, 2022, states will be eligible to receive a 10 percentage point increase in their federal medical assistance percentage (FMAP)—the share of state Medicaid spending that is paid for by the federal government—for specified HCBS. This brief describes ARPA’s HCBS FMAP increase provision, the requirements for states receiving the enhanced federal funding, and considerations and next steps for state policymakers.
On March 11, President Biden signed an approximately $1.9 trillion COVID-19 relief bill—the American Rescue Plan Act of 2021 (“the American Rescue Plan,” ARPA). The American Rescue Plan includes myriad health care provisions, focused primarily in two areas: first, it provides funding the Biden administration requested to carry out its COVID-19 response plans; second, it enacts significant but largely temporary coverage policies. Although all health care coverage provisions of the bill are temporary, many will have a lasting impact. This timeline provides the start and end dates for key health care provisions to help states plan for implementation and future policymaking.
On Tuesday, March 23, State Health and Value Strategies hosted a webinar to discuss how to best communicate with consumers and other stakeholders so residents can take full advantage of new financial help through the Marketplace, free COBRA plans, and more provided by the American Rescue Plan. The webinar was the third in a series that SHVS is hosting on the American Rescue Plan Act of 2021. Experts from GMMB walked through key questions to consider, thoughts on audience segmentation, initial messaging and potential outreach tactics. We also heard from states on their real-time communication plans for rollout.
On Tuesday, March 16, State Health and Value Strategies hosted the second of three webinars to address key provisions of the American Rescue Plan Act of 2021. The $1.9 trillion budget reconciliation package was signed into law by President Biden on March 11. The legislation is wide-ranging, seeking to support Americans as we continue to recover from the fallout of the COVID-19 pandemic and economic downturn. This second webinar, with experts from Manatt Health, reviewed key Medicaid provisions and state/local relief funding included in the COVID-19 relief package. Presenters also discussed considerations for state policymakers as they look to implement the American Rescue Plan, and how some proposals that did not end up in the final legislation could foreshadow future policy priorities.
The Tracking Medicaid Enrollment Growth During COVID-19 Databook provides a comprehensive, detailed look at Medicaid enrollment trends to-date. Using Medicaid enrollment data from over 40 states, the Databook provides a comprehensive, detailed look at Medicaid enrollment trends from the beginning of the COVID-19 pandemic through January 2021. The Databook provides enrollment detail by state across four eligibility categories: expansion adults, children (including those enrolled in CHIP), non-expansion adults, and aged, blind, and disabled individuals. It also compares enrollment trends across expansion and non-expansion states. The Databook has been updated through January, 2021.
This document provides excerpts of health disparities and health equity contract language from Medicaid managed care (MMC) contracts from 12 states and the District of Columbia as well as the contract for California’s state-based marketplace, Covered California. The criteria for inclusion in this compendium were contracts that explicitly addressed health disparities and/or health equity. Website links to the full contracts are included where available.