This 152-day extension then ends on October 9. CMS requires states to develop operational plans for how they will approach the unwinding process. CLARIFICATION: This report has been updated to clarify that the Congressional Budget Office expects the public health emergency for Covid will expire in July, barring another extension. %PDF-1.6 % Get an email every time we post. An Informational Bulletin (CIB) posted on January 5, 2023 included timelines for states to submit a renewal redistribution plan. The public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. As the end of the continuous enrollment provision approaches, states can collaborate with health plans and community organizations to conduct outreach to enrollees about the need to complete their annual renewal during the unwinding period. A proposed rule, released on September 7, 2022, seeks to streamline enrollment and renewal processes in the future by applying the same rules for MAGI and non-MAGI populations, including limiting renewals to once per year, prohibiting in-person interviews and requiring the use of prepopulated renewal forms. And if youre no longer eligible for Medicaid, youre almost certainly eligible for an employer-sponsored plan, Medicare, or a subsidized plan in the marketplace. She has written dozens of opinions and educational pieces about theAffordable Care Actfor healthinsurance.org. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. There are also monthly reporting rules included in the law, designed to ensure transparency and accountability throughout the unwinding of the FFCRAs continuous coverage requirements. These enhanced reporting metrics require states to report the total number of individuals renewed and those renewed on an ex parte basis, break out Medicaid terminations for childrens coverage and pregnancy-related coverage, report the number of individuals whose coverage was terminated for procedural reasons, including breakouts for childrens coverage and pregnancy-related coverage, and report total call center volume, average wait time, and average abandonment rate. Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . Under the previous rules, established by the Families First Coronavirus Response Act, states would have been allowed to start redetermining Medicaid eligibility after the end of the month that the PHE ended. Starting April 1, 2023, states can resume Medicaid disenrollments. What should you do if you currently have Medicaid coverage? The original date for resumption of payments is June 30 and that is still likely to continue, but if the Supreme Court issues a decision before the end of April that date would change. But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage. Note: This brief was updated Feb. 22, 2023, to include more recent and additional data. The overriding thing state Medicaid agencies want is certainty about what is coming, Jack Rollins, the director of federal policy for the National Association of Medicaid Directors, told POLITICO. Medicaid and CHIP Services Information for People Receiving Services English Espaol In response to the COVID-19 pandemic, the federal government declared a public health emergency (PHE) and passed a law that allowed you to automatically keep your Medicaid coverage (continuous Medicaid). March 31, 2023 is the last day that states have to maintain the continuous coverage rules that have been in place since March 2020. And if this passes, Congress will essentially give states a 98-day notice.. Some people who will lose Medicaid eligibility are now eligible for Medicare instead. So, there is some ambiguity as to when payments will be required to resume. This is something both Democratic and Republican states asked for so that the 90 million people enrolled in Medicaid can be given certainty and protected during this massive undertaking.. But this will not happen all at once, as each state will have its own approach to the resumption of eligibility redeterminations. Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California. 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision, 10 Things to Know About Medicaid Managed Care, FAQs on Health Spending, the Federal Budget, and Budget Enforcement Tools, Health Insurer Financial Performance in 2021. A recent analysis of churn rates among children found that while churn rates increased among children of all racial and ethnic groups, the increase was largest for Hispanic children, suggesting they face greater barriers to maintaining coverage. Verify that your information is correct and select Place My Order. during which you can transition to Medicare without any late enrollment penalties. Prescribed Pediatric Extended Care services by 15% effective October 1, 2022 through the end of the public health emergency. Outside GOP advocates working closely with Congress argued that if those guardrails are built too high, the policy move might not yield the federal revenue thats driving the discussion in the first place. This increase is in large part due to the extension of the COVID-19 pandemic public health emergency (PHE).2 Due to the maintenance of effort requirements under the Families First Coronavirus Response Act (FFCRA), which has precluded most forms of involuntary disenrollment from Democrats are on the record as being open to that, a Senate Republican aide told POLITICO. For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. Lastly, states are required to maintain up to date contact information and attempt to contact enrollees prior to disenrollment when mail is returned. We do not sell insurance products, but this form will connect you with partners of healthinsurance.org who do sell insurance products. The lack of certainty is weighing on states and Medicaid stakeholders. The Congressional Budget Office assumes the public health emergency for Covid will expire in July barring another extension by the Biden administration. Based on illustrative scenariosa 5% decline in total enrollment and a 13% decline in enrollmentKFF estimates that between 5.3 million and 14.2 million people will lose Medicaid coverage during the 12-month unwinding period (Figure 2). The share of people who lack health insurance coverage dropped to 8.6% in 2021, matching the historic low in 2016, largely because of increases in Medicaid coverage, and to a lesser extent, increases in Marketplace coverage. For example, California and Rhode Island are planning to automatically enroll some people who lose Medicaid eligibility into a marketplace plan in their area (although they would still have the normal 60-day window to select a different plan or opt-out if they dont want marketplace coverage). States can also work with community health centers, navigators and other assister programs, and community-based organizations to provide information to enrollees and assist them with updating contact information before the continuous enrollment period ends, completing the Medicaid renewal process, and transitioning to other coverage if they are no longer eligible. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. ts noteworthy that the additional federal Medicaid funding that states have received is. If you no longer meet your states Medicaid eligibility guidelines, its a good idea to understand what your options will be when your state begins disenrolling people who are no longer eligible. The main point to keep in mind is that the opportunity to transition to new coverage, from an employer, Medicare, or through the marketplace, is time-limited, although the unwinding SEP described above (announced in late January 2023) gives people significantly more flexibility in terms of being able to enroll in a plan through HealthCare.gov after losing Medicaid during the 16-month window that starts March 31, 2023. Republicans pushing for the deal have also been reminding Democrats that their original Build Back Better legislative package which ultimately became the Inflation Reduction Act and passed this year after being significantly whittled down included a wind-down of the public health emergency as a pay-for. assuming the administration keeps its promise, Unwinding Wednesday #22: Updates to 50-State Tracker with One Month Until Unwinding Start Date, Center for Renewing America Budget Plan Would Cut Federal Medicaid Spending by One-Third, Repeal Affordable Care Acts Coverage Expansions, Federal Medicaid Expansion Incentives Offer Another Tool for States to Continue Coverage as Pandemic-Era Medicaid Rules End. That's at least in part due to 2020's Families First Coronavirus Response Act, which required state Medicaid programs to keep beneficiaries enrolled through the duration of the pandemic. The lower estimate accounts for factors, such as new people enrolling in the program as well as people disenrolling then re-enrolling in the program within the year, while the higher estimate reflects total disenrollment and does not account for churn or new enrollees. States that accept the enhanced federal funding can resume disenrollments beginning in April but must meet certain reporting and other requirements during the unwinding process. You can share your story about the impact of the Public Health Emergency HERE. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. A survey of health centers conducted in late 2021 found that nearly 50% of responding health centers reported they have or plan to reach out to their Medicaid patients with reminders to renew their coverage and to schedule appointments to assist them with renewing coverage. While the number of Medicaid enrollees who may be disenrolled during the unwinding period is highly uncertain, it is estimated that millions will lose coverage. Contact Us, 2023 Center for Children & Families (CCF) of the Georgetown University Health Policy Institute, McCourt School of Public Policy, Georgetown University | 600 New Jersey Ave. NW | Washington, DC 20001 | 202.784.3138, Georgetown Center for Children and Families Homepage, Percent of Children Covered by Medicaid/CHIP by Congressional District, 2018, Percent of Adults Covered by Medicaid/CHIP by Congressional District, 2018, renewed the COVID-related public health emergency. Save my name, email, and website in this browser for the next time I comment. You can unsubscribe anytime you want. A trusted independent health insurance guide since 1994. Were hopeful that states will work to make the redeterminations and renewals process as transparent, accurate, and simple as possible. And those renewals must be completed no later than May 31, 2024, This 12-month period to initiate renewals and 14-month period to complete them had already been the case under previous guidance that the Biden administration had issued. CMS guidance provides a roadmap for states to streamline processes and implement other strategies to reduce the number of people who lose coverage even though they remain eligible. The move will maintain a range of health benefits . While the share of individuals disenrolled across states will vary due to differences in how states prioritize renewals, it is expected that the groups that experienced the most growth due to the continuous enrollment provisionACA expansion adults, other adults, and childrenwill experience the largest enrollment declines. The COVID-19 Public Health Emergency (PHE) that was declared in March 2020 is set to end on May 11, 2023, as the President has announced there will be no more extensions to the PHE. The Department of Health and Human Services (HHS) has extended the public health emergency eight times and is currently set to expire in April 2022. Under the ACA, states must seek to complete administrative (or ex parte) renewals by verifying ongoing eligibility through available data sources, such as state wage databases, before sending a renewal form or requesting documentation from an enrollee. For system readiness reporting, states are required to demonstrate that their eligibility systems for processing renewals are functioning correctly, particularly since states have not been conducting normal renewals while the continuous enrollment provision has been in effect. HHS Secretary Xavier Becerra last renewed the COVID public health emergency on Jan. 11, 2023. | Jae C. Hong/AP Photo. As part of a Covid-19 relief package passed in March 2020, states were barred from kicking people off Medicaid during the public health emergency in exchange for additional federal matching funds. Healthcare Dive reports that the majority of people with Medicaid do not know that their coverage could end when the public health emergency ends. The GOP-led Senate passed the proposal in the 2022 session, but it was killed in the House. But we need to leverage every method to reach people on the program.. When the continuous enrollment provision ends and states resume redeterminations and disenrollments, certain individuals will be at increased risk of losing Medicaid coverage or experiencing a gap in coverage due to barriers completing the renewal process, even if they remain eligible for coverage. HHS says it plans to extend Covid-19 public health emergency - POLITICO Health Care HHS says it plans to extend Covid-19 public health emergency An extension would ensure expanded. However, in many states, the share of renewals completed on an ex parte basis is low. 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