The ARP is still making premiums more affordable. Lawmakers and staff have been scrambling for weeks to find ways to pay for a slew of health care programs, such as permanent telehealth flexibility, providing longer Medicaid coverage for new mothers and avoiding scheduled cuts to doctors payments, prompting formerly resistant Democratic members to take a fresh look at moving up the end-date of the Covid-19 Medicaid policy by at least three months to April 1. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 There are a number of waivers that ANA would like to become permanent. Gov. A nationwide public health emergency is in effect. 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. The public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. The PHE has been in place since January 27, 2020, and renewed throughout the pandemic. Low-income enrollees will able to enroll in ACA coverage during a special enrollment period. 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. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision. Its noteworthy that the additional federal Medicaid funding that states have received is more than double the extra cost that states have incurred to cover the FFCRA-related enrollment growth. 7.8 million enrollees by March 2023. That same analysis revealed that a majority of states provide general information about reasonable modifications and teletypewriter (TTY) numbers on or within one click of their homepage or online application landing page (Figure 8), but fewer states provide information on how to access applications in large print or Braille or how to access American Sign Language interpreters. People using this window can, If youre eligible for Medicare, youll have. Its clear their support and openness to it is contingent on reinvesting the savings back into Medicaid in a permanent way. If BBB had been enacted in December, states would have had three months to get ready. 3. 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. States are also required to report on transitions to separate CHIP programs and to Marketplace or Basic Health Program coverage (Figure 10). But they could choose to do so, and could also choose to waive premiums for CHIP during that time. HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. But enrollment has trended upward throughout the pandemic, without the normal disenrollments that previously stemmed from the regular Medicaid eligibility redetermination process. This brief describes 10 key points about the unwinding of the Medicaid continuous enrollment requirement, highlighting data and analyses that can inform the unwinding process as well as recent legislation and guidance issued by the Centers for Medicare and Medicaid Services (CMS) to help states prepare for the end of the continuous enrollment provision. Medicaid is a prime example: As of late 2022, enrollment in Medicaid/CHIP stood at nearly 91 million people, with more than 19 million new enrollees since early 2020. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). Republicans have long called for ending the public health emergency for Covid-19 and have forced a handful of successful Senate votes that were then blocked in the House. Because of specific Congressional action many of the telehealth flexibilities authorized under the PHE will continue through the end of 2024. CMS requires states to develop operational plans for how they will approach the unwinding process. 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. Share on Facebook. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). 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. Medicaid enrollment increased by over 17 million from February 2020 to May 2022. This window, If you do not have access to an employer-sponsored health plan, you can apply for a premium tax credit (subsidy) to offset the cost of coverage in the, The subsidies that are currently available in the marketplace are particularly generous, thanks to the, If youre in a state that hasnt expanded Medicaid under the ACA and your income is below the poverty level, you may find yourself in the. This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made, and summarizes the flexibilities triggered by each in the following. Democrats, in contrast, have been hesitant to tie the administrations hands as the virus continues to kill hundreds of people each day and a winter surge of several illnesses strains the countrys medical system. 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. Especially after reports showing worsening health outcomes for mothers, investing these funds into extending Medicaid postpartum coverage is critical, said Rep. Robin Kelly (D-Ill.), who leads the health care task force for the Congressional Black Caucus. About 4.2% were disenrolled and then re-enrolled within three months and 6.9% within six months. But the situation is evolvingas of February 3, 2023, 41 states had posted their full plan or a summary of their plan publicly. But the Consolidated Appropriations Act, 2023 ensures that states continue to receive at least some additional federal Medicaid funding throughout 2023. But our goal today is to help you understand what you need to know in order to maintain coverage if youre one of the millions of people who could potentially lose Medicaid eligibility in the coming months. Learn more at ConnectForHealthCO.com or 855-752-6749: Get expert help signing up for health coverage by working with a certified assister or broker, online or in person. She has written dozens of opinions and educational pieces about theAffordable Care Actfor healthinsurance.org. Ensuring accessibility of information, forms, and assistance will be key for preventing coverage losses and gaps among these individuals. 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. 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. Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. Additionally, people with LEP and people with disabilities are more likely to encounter challenges due to language and other barriers accessing information in needed formats. No one thought the public health emergency would stay forever. Congress has extended the telehealth flexibility through the end of 2024, but it is unclear if it will be extended further or made permanent. But if the answer is no, be prepared for a coverage termination notice at some point after the end of March 2023. We didnt see that happen in 2020, thanks in large part to the availability of Medicaid and CHIP. 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. (Prior to the pandemic, states had to recheck each enrollees eligibility at least once per year, and disenroll people who were no longer eligible. But because Democrats are squeamish about this, theyre going to use it to drive a hard bargain. 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. 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. A PHE can be extended as many times as deemed necessary by the Secretary. Other than that, if you miss the special enrollment period for your particular coverage, youll have to wait until the next annual open enrollment period to sign up for coverage (employers set their own annual enrollment windows; Medicares general enrollment period is January March each year). And since coverage cannot be backdated, its essential to ensure that youre covered before any medical needs arise. Can I use my Medicaid coverage in any state? . The COVID-19 pandemic cast a spotlight on the importance of the various safety net systems that the U.S. has in place. HHS projects that nearly 8% of current Medicaid enrollees will lose their coverage despite continuing to be eligible once eligibility redeterminations resume. Helping millions of Americans since 1994. Omnibus spending bill allows states to resume Medicaid eligibility redeterminations in April. 506 0 obj <> endobj If providers finish submitting their evidence by that date, then the Department would be in a position to verify the evidence and confirm compliance in early 2023. You may have to submit documentation to the state to prove your ongoing eligibility, so pay close attention to any requests for information that you receive. Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work. 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. If you dont have access to an employer-sponsored plan and you are eligible for marketplace subsidies (most people are), the best course of action is to enroll in a marketplace plan as soon as you know that your Medicaid coverage will be terminated, in order to avoid or minimize a gap in coverage. March 31, 2023 is the last day that states have to maintain the continuous coverage rules that have been in place since March 2020. A majority of states also indicated they were taking steps to update enrollee contact information and were planning to follow up with enrollees before terminating coverage. It can be allowed to expire at the end of the 90-day period or terminated early if deemed appropriate. You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. As part of the Consolidated Appropriations Act, 2023, signed into law on December 29, 2022, Congress set an end of March 31, 2023 for the continuous enrollment provision, and phases down the enhanced federal Medicaid matching funds through December 2023. 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. The Biden administration announced its intention to end the federal public health emergency on May 11, 2023. 4. 3168 0 obj <> endobj Key Points. This would have incentivized some states to act as quickly as possible to disenroll people from Medicaid. Can you appeal your states decision to disenroll you? The move will maintain a range of health benefits . Your email address will not be published. The new rules give states a clear time frame: They can begin to initiate the renewal/redetermination process as early as February 1, 2023 (states can start this in February, March, or April), and disenrollments can be effective as early as April 1, 2023 if adequate notice is given to the enrollee. As states return to routine operations when the continuous enrollment provision ends, there are opportunities to promote continuity of coverage among enrollees who remain eligible by increasing the share of renewals completed using ex parte processes and taking other steps to streamline renewal processes (which will also tend to increase enrollment and spending). The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. CMS guidance also outlines specific steps states can take, including ensuring accessibility of forms and notices for people with LEP and people with disabilities and reviewing communications strategies to ensure accessibility of information. uyx'tE!~YV.v.wDO @:Z98-PtinB*[Elrcr[b8B9NX5IR'[UC.ok"zf3itMAiP((ISh. President Biden says the emergency order will expire May 11. 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. Importantly, these findings also show that large shares of enrollees (41% in the KFF analysis) reenroll in Medicaid after a period of time, and many after a period of uninsurance. %%EOF With respect to Medicare: We do not offer every plan available in your area. HHS Secretary Xavier Becerra last renewed the COVID public health emergency on Jan. 11, 2023. 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. endstream endobj 507 0 obj <. 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. 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. How states approach the unwinding process will have implications for the ability of eligible individuals to retain coverage and those who are no longer eligible to transition to other coverage. And the Consolidated Appropriations Act, 2023 provides for the additional federal Medicaid funding to gradually decrease throughout 2023, instead of ending abruptly at the end of the quarter in which the PHE ends. First, the maintenance of effort provisions in the Families First Coronavirus Response Act remain in effect until January 31, 2022 (the end of the month after the PHE ends). during which you can transition to Medicare without any late enrollment penalties. A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994. CMS notes in recent guidance that states can increase the share of ex parte renewals they complete without having to follow up with the enrollee by expanding the data sources they use to verify ongoing eligibility. On January 30, 2023, the Biden administration announced its intention to make final extensions of both the COVID-19 National Emergency (NE) and the COVID-19 Public . 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 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. 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. 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. Without it, millions of additional Americans would have joined the ranks of the uninsured. Brief What Will Happen to Medicaid Enrollees' Health Coverage after the Public Health Emergency . Estimates indicate that among full-benefit beneficiaries enrolled at any point in 2018, 10.3% had a gap in coverage of less than a year (Figure 3). Some people who will lose Medicaid eligibility are now eligible for Medicare instead. 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. Democrats are on the record as being open to that, a Senate Republican aide told POLITICO. The latest extension will expire on April 16, 2022. As a result, individuals who were enrolled in HUSKY Health may have their benefits extended . How many people will lose Medicaid coverage when the continuous coverage requirement ends? %PDF-1.7 % 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. 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. To fully assess the impact of the unwinding will require broader outcome measures, such as continuity of coverage across Medicaid, CHIP, Marketplace, and employer coverage, gaps in coverage over time, and increases in the number of the uninsured, data that will not be available in the short-term. 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. Without other action, states can start disenrolling people beginning May 1, 2022. Its only a pay-for because youd be removing people from Medicaid, said Brian Blase, the president of the conservative Paragon Health institute and a former senior Senate Republican aide. The Biden Administration announced on January 30 that the COVID-19 national public health emergency (PHE) will end on May 11, 2023. . MOUNT VERNON As the COVID-19 public health emergency nears its end, eligible families and individuals risk losing Medicaid coverage and SNAP food stamp benefits through a process often called "unwinding." "The changes that are upon us do not necessarily affect everybody, but a lot of people accustomed to getting Medicaid or SNAP, if . Please contact Medicare.gov or 1800 MEDICARE to get information on all of your options. 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. Moreover, research shows that when parents gained coverage under the Medicaid expansion, Medicaid participation among their eligible but unenrolled children also increased. The Centers for Medicare & Medicaid Services (CMS) implemented several interim final rules during the PHE. The PHE is expected to continue until mid-May 2023. And if youve moved or your contact information has changed since you first enrolled in Medicaid, make sure the state has your current contact information on file. On April 12, 2022, the Secretary of Health and Human Services (HHS), Xavier Becerra, announced the extension of the public health emergency (PHE) related to the Coronavirus Disease 2019 (COVID-19) pandemic. Heres what enrollees need to know. CMS is ending the requirement that the supervising clinician be immediately available at the end of the calendar year where the PHE ends. endstream endobj startxref But during the PHE, these individuals have not had their Medicaid coverage terminated. Preparing for the End of COVID-19: Return to Regular Renewals . Read about your data and privacy. We are not ending the PHE, said a Capitol Hill source close to the negotiations, granted anonymity to discuss a deal that is still in flux. In some states, it will be the most significant enrollment action in the 50+ year history of Medicaid. By law, public health emergencies are declared in 90-day increments. The Centers for Medicare & Medicaid Services (CMS) has released numerous guidance documents and tools designed to help states. Section 319 of the Public Health Service Act gives the federal HHS Secretary the authority to make such a declaration when a severe disease . Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. 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. 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.. | T p{YWY4,;U|p9 In the Calendar Year (CY) 2022 Home Health Prospective Payment System (PPS) final rule, CMS snuck . 01:02. (Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . 0 US Department of Health and Human Services Secretary Xavier Becerra . Dig Deeper Medicaid Spending on. [Editors Note: Read the latest on the public health emergency Medicaid continuous coverage protectionhere.]. 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. There is no doubt that some people currently enrolled in Medicaid are no longer eligible due to income increases since they enrolled in the program. All orders will be shipped via First Class Package Service. 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. Louise Norrisis anindividual health insurancebroker who has been writing about health insurance and health reform since 2006. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. Home > Blog > Medicaid eligibility redeterminations will resume in 2023. 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. 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. 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 recently enacted Consolidated Appropriations Act includes additional reporting requirements for states and imposes penalties in the form of reduced federal matching payments for states that do not comply. 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. So, there is some ambiguity as to when payments will be required to resume. These waivers include strategies allowing states to: renew enrollee coverage based on SNAP and/or TANF eligibility; allow for ex parte renewals of individuals with zero income verified within the past 12 months; allow for renewals of individuals whose assets cannot be verified through the asset verification system (AVS); partner with managed care organizations (MCOs), enrollment brokers, or use the National Change of Address (NCOA) database or US postal service (USPS) returned mail to update enrollee contact information; extend automatic enrollment in MCO plans up to 120 days; and extend the timeframe for fair hearing requests. 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. Written by Diane Archer. For people whose income has increased enough to make them ineligible for Medicaid, but still eligible for this special enrollment period, there will be more flexibility in terms of access to coverage. States will be eligible for the phase-down of the enhanced FMAP (6.2 percentage points through March 2023; 5 percentage points through June 2023; 2.5 percentage points through September 2023 and 1.5 percentage points through December 2023) if they comply with certain rules. As of January 10, 2023, CMS had approved a total of 158 waivers for 41 states (Figure 6). 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). Of additional Americans would have had three months and 6.9 % within six months via a when! ) has released numerous guidance documents and tools designed to help states documents and tools to... 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