(As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). Regardless of timing, the lifting of the continuous enrollment requirement will have a substantial impact on states and Medicaid enrollees, particularly in states that have been unable to renew coverage automatically for a significant portion of enrollees. For those individuals, there will generally be two primary options for post-Medicaid coverage: An employer-sponsored plan, or a plan obtained in the health insurance exchange/marketplace. US Department of Health and Human Services Secretary Xavier Becerra . At the start of the pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA), which included a requirement that Medicaid programs keep people continuously enrolled through the end of the month in which the COVID-19 public health emergency (PHE) ends, in exchange for enhanced federal funding. This will be the case, for example, for someone who was enrolled under Medicaid expansion guidelines (which only apply through age 64) and has turned 65 during the PHE. Medicaid eligibility redeterminations will resume in 2023. So, there is some ambiguity as to when payments will be required to resume. Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work. Note: This brief was updated Feb. 22, 2023, to include more recent and additional data. The Biden administration on Friday extended the Covid-19 public health emergency for another three months. In the Calendar Year (CY) 2022 Home Health Prospective Payment System (PPS) final rule, CMS snuck . Brief What Will Happen to Medicaid Enrollees' Health Coverage after the Public Health Emergency . People using this window can elect to have their Medicare coverage retroactive to the day after their Medicaid ended, although any back premiums would have to be paid in that case. But enrollment has trended upward throughout the pandemic, without the normal disenrollments that previously stemmed from the regular Medicaid eligibility redetermination process. CMS requires states to develop operational plans for how they will approach the unwinding process. If youve recently submitted renewal information to your state and its clear that youre still eligible, your coverage will continue as usual until your next renewal period. By preventing states from disenrolling people from coverage, the continuous enrollment provision has helped to preserve coverage during the pandemic. This additional match will be slowly wound down through 2023 and the federal match will be returned to what it had been prior to the PHE in January 2024. The Biden administration appears headed toward extending the COVID-19 public health emergency for another three months, allowing special powers and programs to continue past the midterm election. 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. Can you appeal your states decision to disenroll you? 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. The state has to make a good-faith effort to find the person first. The Centers for Medicare & Medicaid Services (CMS) implemented several interim final rules during the PHE. The Biden administration extended the U.S. coronavirus public health emergency, now more than two years old, for another 90 days on Wednesday. hbbd``b`$ = $: " Ms ]@B#F_ E+ Collectively, these metrics are designed to demonstrate states progress towards restoring timely application processing and initiating and completing renewals of eligibility for all Medicaid and CHIP enrollees and can assist with monitoring the unwinding process to identify problems as they occur. The Biden administration has extended the public health emergency (PHE) for 90 days, from October 18, 2021 through January 16, 2022. PA MEDI Counselors are specially trained to answer your questions and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance. Twenty-two states complete less than 50% of renewals on an ex parte basis, including 11 states where less than 25% of renewals are completed using ex parte processes (Figure 5). | Jae C. Hong/AP Photo. Efforts to conduct outreach, education and provide enrollment assistance can help ensure that those who remain eligible for Medicaid are able to retain coverage and those who are no longer eligible can transition to other sources of coverage. 2022 Congressional Spending Bill Included Several ANA-Supported Nursing Provisions to Cap off the Year, The End of the Public Health Emergency and What this Means for Nurses, APRNs Can Provide Quality and Access to Care and Congress Needs to Let Them, Introducing the Safe Staffing for Nurse and Patient Safety Act, House Tax Bills Impacts on Nurses and Consumers, House Tax Bills Impacts on Nurses and Consumers Capitol Beat, Better Late, Than Never House and Senate Make Moves on CHIP. Many states have continued to send out these renewal notifications and information requests throughout the pandemic (nearly all states have been conducting automatic (ex parte) renewals when possible, and more than half the states have also been sending renewal forms to enrollees). The Administration's plan is to end the COVID-19 public health emergency (PHE) on May 11, 2023. According to an Urban Institute analysis, about a third of the people losing Medicaid will be eligible for premium tax credits (subsidies) in the marketplace, while about two-thirds will be eligible for employer-sponsored coverage that meets the ACAs definition of affordable. Oral arguments on the program were argued before the Supreme Court on February 28, and a decision is expected this Term. The U.S. Department of Health and Human Services can extend the public health emergency in 90-day increments; it is currently set to end April 16. Eligible individuals are at risk for losing coverage if they do not receive or understand notices or forms requesting additional information to verify eligibility or do not respond to requests within required timeframes. Both . States are also required to report on transitions to separate CHIP programs and to Marketplace or Basic Health Program coverage (Figure 10). Click Check Out Now. Of the 42 states processing ex parte renewals for MAGI groups (people whose eligibility is based on modified adjusted gross income), only 11 states report completing 50% or more of renewals using ex parte processes. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision. 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. There is normally quite a bit of turnover in the Medicaid program, with some people losing eligibility each month. The recent CIB notes that CMS is expected to issue guidance to address how new reporting requirements (discussed below) may intersect with the requirements described in prior CMS guidance. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 V,wfBt3 [ho Update regarding intent to end the national emergency and public health emergency declarations and extensions by way of the Consolidated Appropriations Act (CAA) for Fiscal Year 2023 Update: On Thursday, December 29, 2022, President Biden signed into law H.R. As COVID-19 becomes less of a threat and the federal government's public health emergency ends, states will restart yearly Medicaid and Children's Health Insurance Program (CHIP) eligibility reviews beginning April 1, 2023. Medicaid enrollees should pay close attention to redetermination notices that they may receive once normal eligibility redeterminations resume. 528 0 obj <>/Filter/FlateDecode/ID[<3C6513E815B48242A21C94DD62711375>]/Index[506 36]/Info 505 0 R/Length 108/Prev 319214/Root 507 0 R/Size 542/Type/XRef/W[1 3 1]>>stream However, we know Congress is considering delinking the FMAP bump and continuous enrollment and other maintenance of effort provisions from the PHE. What does this mean for Medicaid? Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. A majority of responding MCOs reported that they are sending updated member contact information to their state; nearly all said their state is planning to provide monthly files on members for whom the state is initiating the renewal process and more than half indicated that information would include members who have not submitted renewal forms and are at risk of losing coverage; and more than half of plans reported their state is planning to provide periodic files indicating members whose coverage has been terminated . However, when states do need to follow up with enrollees to obtain additional information to confirm ongoing eligibility, they can facilitate receipt of that information by allowing enrollees to submit information by mail, in person, over the phone, and online. 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. Thats because Medicaid and CHIP eligibility for children extend to significantly higher income ranges, and marketplace subsidies are never available if a person is eligible for Medicaid or CHIP. 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. For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. For the first quarter of 2023, states will continue to get the 6.2 percentage point boost that theyve been receiving throughout the pandemic. With respect to Medicare: We do not offer every plan available in your area. Additionally, nearly six in ten assister programs said they had proactively reached out to their state to explore ways to help consumers; supported the state sharing contact information with them on individuals who need to renew their Medicaid coverage; and were planning to recontact Medicaid clients to update their contact information. What are your options if youre no longer eligible for Medicaid? And if this passes, Congress will essentially give states a 98-day notice.. A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994. Some states suspended renewals as they implemented the continuous enrollment provision and made other COVID-related adjustments to operations. ANA has worked with the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) on making waivers permanent, but CMS believes that they do not have the authority to make any additional waivers permanent. 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. March 31, 2023 is the last day that states have to maintain the continuous coverage rules that have been in place since March 2020. (Prior to the pandemic, states had to recheck each enrollees eligibility at least once per year, and disenroll people who were no longer eligible. (Note that there are several terms that are used interchangeably: Eligibility redetermination, renewal, case review, recertification, and redetermination all mean the same thing, and refer to the process by which the state determines whether a Medicaid enrollee is eligible to continue to receive Medicaid.). 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. Those participating in the negotiations caution that some details remain unresolved and the deal could still fall apart as lawmakers and staff rush to finalize the bill language, but interest from both sides is mounting. Healthcare Dive reports that the majority of people with Medicaid do not know that their coverage could end when the public health emergency ends. For additional resources about the end of the PHE, you can visit the websites below: https://www.cms.gov/files/document/what-do-i-need-know-cms-waivers-flexibilities-and-transition-forward-covid-19-public-health.pdf, https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html, Your email address will not be published. The resumption of eligibility redeterminations is no longer linked to end of public health emergency. This provision requires states to provide continuous coverage for Medicaid enrollees until the end of the month in which the public health emergency (PHE) ends in order to receive enhanced federal funding. However, if the guardrails are too flimsy or non-existent, states could see a surge in their uninsured populations right as government Covid funding runs dry, and individuals will have to depend on health plans to cover tests, vaccines and therapeutics for the virus. The Consolidated Appropriations Act, 2023 decouples the Medicaid continuous enrollment provision from the PHE and terminates this provision on March 31, 2023. However, there will also be current enrollees who are determined to be no longer be eligible for Medicaid, but who may be eligible for ACA marketplace or other coverage. The White House's Department of Health and Human Services (HHS) has extended the COVID-19 state of emergency. 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. In 2020, one in ten Medicaid enrollees moved in-state and while shares of Medicaid enrollees moving within a state has trended downward in recent years, those trends could have changed in 2021 and 2022. Would love your thoughts, please comment. Under the tentative deal, much of the money saved would go to two Medicaid policies Democrats have long sought: a year of postpartum coverage for low-income moms in states that dont already offer it and a year of continuous coverage provisions for children at risk of losing health insurance. But during the PHE, these individuals have not had their Medicaid coverage terminated. You can share your story about the impact of the Public Health Emergency HERE. Any information we provide is limited to those plans we do offer in your area. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. Sharing updates regarding the end of public health emergency declarations and extensions by way of the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. . Verify that your information is correct and select Place My Order. But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. In some states, it will be the most significant enrollment action in the 50+ year history of Medicaid. Lastly, states are required to maintain up to date contact information and attempt to contact enrollees prior to disenrollment when mail is returned. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. Reducing the number of people who lose coverage for procedural reasons even though they remain eligible can also help to reduce the number of people who become uninsured. By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. expected to be extended again in January 2023, Medicaid eligibility redetermination process, very difficult to plan for the resumption of Medicaid eligibility redeterminations, Childrens Health Insurance Program (CHIP), were not required to suspend CHIP disenrollments during the pandemic, Texas is an example of a state taking this approach, Virginia is an example of a state taking this approach, Tennessee is an example of a state taking this approach, Georgia is an example of a state taking this approach, continued to send out these renewal notifications and information requests, Medicaid and CHIP eligibility for children extend to significantly higher income ranges, Medicaid eligibility rules are much different (and include asset tests) for people 65 and older, elect to have their Medicare coverage retroactive to the day after their Medicaid ended, But it will start to apply again as of June 10, 2023, health insurance marketplace in your state, pleasantly surprised to see how affordable the coverage will be, read this article about strategies for avoiding the coverage gap, the income levels that will make you eligible, American Rescue Plans subsidy enhancements. Under normal circumstances, they would have lost their Medicaid eligibility upon turning 65, as the Medicaid eligibility rules are much different (and include asset tests) for people 65 and older. CMS is ending the requirement that the supervising clinician be immediately available at the end of the calendar year where the PHE ends. However, while the new data reporting requirements are useful, they will not provide a complete picture of how the unwinding is proceeding and whether certain groups face barriers to maintaining coverage. 0 The Consolidated Appropriations Act, 2023 (enacted in December 2022) has given states a specific date April 1, 2023 when they can begin terminating coverage for enrollees who are no longer eligible. Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270, www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff. Republicans have long demanded an end to the Covid-era Medicaid policy that gives states more funding and bars them from kicking people off the rolls. Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California. But that was an uncertain and ever-changing date, as the PHE has continued to be extended. In the second quarter, that will drop to 5 percentage points. Were providing certainty to states and giving them a gradual stream of funding and guardrail requirements that protect people. Throughout the COVID-19 public health emergency (PHE), CMS has used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure access to care and give health care providers the flexibilities needed to respond to COVID-19 and help keep people safer. Under the prior rules, that would have meant that Medicaid eligibility redeterminations (and terminations) could have resumed as of June 2023. %%EOF HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. If youre currently enrolled in Medicaid, its a good idea to familiarize yourself with your states eligibility rules, and figure out whether youd be eligible if you were to apply today, with your current circumstances and income. What are your coverage options if youre disenrolled from Medicaid? So the Consolidated Appropriations Act, 2023 does require states to use the U.S. Post Offices change of address database and/or state Department of Health and Human Services data to ensure that the state has updated contact information for people whose coverage eligibility is being redetermined. CMS guidance about the unwinding of the continuous enrollment provision stresses the importance of conducting outreach to enrollees to update contact information and provides strategies for partnering with other organizations to increase the likelihood that enrollee addresses and phone numbers are up to date. So HHS has finalized a rule change that allows for a six-month special enrollment period during which a Medicare-eligible person who loses Medicaid coverage can transition to Medicare without a late enrollment penalty. While the PHE ends on May 11, in payments rules CMS has extended the waivers for an additional 152 days to allow providers time to undo the waivers. However, waivers that allowed advanced practice registered nurses (APRNs) to practice at the top of their license will expire on October 9 absent further Congressional action. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. Yet Congress signaled change in the final days of 2022. It also provides states more time to prepare for new rules that will put millions in jeopardy of losing their health insurance, something state Medicaid directors have been demanding from legislators. But the continued enrollment growth in Medicaid is primarily due to the fact that the Families First Coronavirus Response Act (FFCRA), enacted in March 2020, has been providing states with additional federal funding for their Medicaid programs, as long as they dont disenroll people from Medicaid during the COVID public health emergency (PHE) period. This should include an email address and cell phone number if you have them, as states are increasingly using email and text messages, as well as regular mail, to contact enrollees. (Note that the Biden administration has implemented a fix for the family glitch, making some employees family members newly eligible for marketplace subsidies in 2023 even with an offer of employer-sponsored coverage.). for medical reasons related to the disaster or public health emergency, or who are otherwise absent from the state . Written by Diane Archer. 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. | T p{YWY4,;U|p9 CMS is releasing the 2022-2023 Medicaid Managed Care Rate Development Guide for states to use when setting rates with respect to any managed care program subject to federal actuarial soundness requirements during rating periods starting between July 1, 2022 and June 30, 2023. On March 18, 2020, the Families First Coronavirus Response Act was signed into law. The lack of certainty is weighing on states and Medicaid stakeholders. For a person who is no longer Medicaid-eligible under normal rules, Medicaid coverage can end as early as April 1, 2023. Even though Congress could still enact some version of the BBB provisions relating to the unwinding of the continuous enrollment requirement, some states would find an April 1, 2022 renewal start date challenging. A trusted independent health insurance guide since 1994. Without it, millions of additional Americans would have joined the ranks of the uninsured. 2022-2023 Medicaid Managed Care Rate Development Guide. Two key public health reauthorizationsthe Pandemic and All-Hazards Preparedness Act (PAHPA) and the President's Emergency Plan for AIDS Relief (PEPFAR)are due for renewal in 2023. For the most up-to-date news and . To reduce the administrative burden on states, CMS announced the availability of temporary waivers through Section 1902(e)(14)(A) of the Social Security Act. 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. Democrats want to make that harder, but if they put too many restrictions on states ability to do that, Im not sure how the math would work out. These projected coverage losses are consistent with, though a bit lower than, estimates from the Department of Health and Human Services (HHS) suggesting that as many as 15 million people will be disenrolled, including 6.8 million who will likely still be eligible. Lawmakers have struck an agreement to move the end of its Medicaid rules up to April 1, which would allow states to begin removing people from the rolls who no longer qualify, usually because their income has increased. This 152-day extension then ends on October 9. There are a number of waivers that ANA would like to become permanent. A nationwide public health emergency is in effect. States have already begun rechecking people with Medicaid for eligibility, Millions of them are at high risk of losing their Medicaid coverage as soon as April 1. How many people will lose Medicaid coverage when the continuous coverage requirement ends? The Congressional Budget Office assumes the public health emergency for Covid will expire in July barring another extension by the Biden administration. The U.S. Department of Health and Human Services (HHS) must renew the federal public health emergency (PHE) related to COVID-19 every 90 days to maintain certain health care flexibilities and waivers. And since coverage cannot be backdated, its essential to ensure that youre covered before any medical needs arise. As states prepare to complete redeterminations for all Medicaid enrollees once the continuous enrollment provision ends, many may face significant operational challenges related to staffing shortages and outdated systems. Find out how much financial help you may qualify for. In January 2020, the federal government enacted a national public health emergency that has since served as the "primary legal pillar of the U.S. pandemic response." 1 The emergency. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. Medicaid provides coverage to a vast. They cannot restrict eligibility standards, methodologies, and procedures and cannot increase premiums as required in FFCRA. The primary things to keep in mind: Your Medicaid coverage will continue if you continue to meet the eligibility guidelines and submit any necessary documentation as soon as its requested by the state. Theres always a risk of scams and abuses should that happen, Rollins cautioned, arguing that the calling and texting ban should only be lifted for the period of the Medicaid redeterminations. Question Is there an association between prenatal care coverage in emergency Medicaid (a program of restricted Medicaid services for recent immigrants with low income who are pregnant) and the use of antidiabetic agents by pregnant Latina individuals with gestational diabetes?. But there are very real concerns that many people who are actually still eligible for Medicaid might lose their coverage due to a lack of understanding of the process, onerous paper-based eligibility redetermination systems, unstable housing/communication situations, etc. Is correct and select Place My Order be required to resume years old for. 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