To maximize efforts to maintain coverage, state Medicaid agencies and Marketplaces can now leverage digital channels as part of their overall outreach and communications efforts. Rapidly evolving changes in consumer media consumption habits as well as shifts in digital channels, and the ability to leverage data sources, enables granular audience targeting and efficient use of resources. These can be incorporated into an overall integrated outreach and education campaign to maximize renewals and coverage retention.

Individual-level data on race and ethnicity collected within the Medicaid program and in other state agencies is greatly influenced by federal guidance. This expert perspective summarizes the proposed revisions to the federal standards for collecting race and ethnicity that are currently out for comment, and provides considerations for states interested in submitting comments.

The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act, with significant health equity implications. Given the intense focus on coverage transitions during the unwinding, some states have initiated plans to publish a data dashboard to monitor progress. To date, three states—Iowa, Minnesota and Utah—have a public data dashboard. SHADAC will update this expert perspective as additional dashboards go live.

State updates as of March 3, 2023.

The long-expected return to Medicaid eligibility re-determinations and renewals, referred to as the “Medicaid unwinding,” has begun. This expert perspective provides a checklist of actions state-based marketplaces and state insurance departments can take, if they haven’t already, to reduce gaps in coverage and minimize disruptions in care. Many are designed to be temporary, and will be critical to helping people navigate an unprecedented period of disruption. Other actions involve policies or operational improvements that could reap long-term benefits by mitigating risks inherent in Medicaid-Marketplace “churn.”

State updates as of February 24, 2023.

State updates as of February 17, 2023.

State updates as of February 10, 2023.

This expert perspective summarizes a recent federal court ruling that impacted the Centers for Medicare & Medicaid Services’ (CMS) enforcement of an interim final rule (IFR) that narrowed CMS’ interpretation of the Medicaid continuous coverage requirement in the Families First Coronavirus Response Act (FFCRA). In November 2022, a federal court in Connecticut ruled in Carr v. Becerra that CMS had acted impermissibly by issuing the IRF in November 2020. On January 31, 2023, the court broadened its order to include all Medicaid enrollees nationwide who had experienced a reduction in Medicaid benefits due to the IFR. The expert perspective discusses potential implications for states and enrollees.

As a result of the Consolidated Appropriations Act, 2023 (CAA), states can start refining and implementing long laid plans to restart eligibility redeterminations and return to routine eligibility and enrollment operations. As part of this process, states will be required to closely track and monitor the impacts of the resumption of eligibility redeterminations and disenrollments and to make that data public. This expert perspective outlines the relevant reporting requirements that were included in the CAA and the corresponding reporting guidance provided by CMS in its January 2023 State Health Official letter, and presents considerations for state officials.