You can unsubscribe anytime you want. 01:02. 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. Further, states must also comply with federal rules about conducting renewals. 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 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). Most of the people who will become eligible for marketplace subsidies will be adults, as children are always much less likely than adults to qualify for marketplace subsidies. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. 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. If the PHE ends in April 2023, the FFCRAs rules would have resulted in the additional federal Medicaid funding (6.2 percentage points added to a states regular federal Medicaid funding) ending altogether at the end of June 2023. 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. endstream endobj startxref Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. Its clear their support and openness to it is contingent on reinvesting the savings back into Medicaid in a permanent way. In a May 2022 letter to governors, HHS noted We strongly encourage your state to use the entire 12-month unwinding period to put in place processes that will prevent terminations of coverage for individuals still eligible for Medicaid as your state works through its pending eligibility actions.. 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. [Editors Note: Read the latest on the public health emergency Medicaid continuous coverage protectionhere.]. 3168 0 obj <> endobj The Administration has stated that payments will resume either sixty days after the Supreme Court renders an opinion or June 30, whichever comes first. On March 18, 2020, the Families First Coronavirus Response Act was signed into law. 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. This process, which is frequently referred to as unwinding, is resuming after three years of being paused, so many current Medicaid enrollees have never experienced routine eligibility redeterminations. Filling the need for trusted information on national health issues, Jennifer Tolbert and The PHE will probably be extended through the first half of 2022, and further extension is possible. Tate Reeves, after months of resistance, asks lawmakers to pass postpartum Medicaid extension by Bobby Harrison February 26, 2023 February 26, 2023. In this brief, we project Medicaid enrollment for the population under age 65 and federal and state Medicaid spending for 2022 and . There will also be continued access to pathways for emergency use authorizations (EUAs) for COVID-19 products (tests, vaccines, and treatments) through the Food and Drug Administration (FDA), and major telehealth flexibilities will continue to exist for those participating in Medicare or Medicaid. 506 0 obj <> endobj The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. (Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). The move will maintain a range of health benefits . This policy update will examine several of the health-related COVID-19 Federal Emergency Declarations and which flexibilities will end in May. The ARP is still making premiums more affordable. Browse plans and costs with an easy, anonymous online tool. About 4.2% were disenrolled and then re-enrolled within three months and 6.9% within six months. If BBB had been enacted in December, states would have had three months to get ready. As a result . This JAMA Forum discusses the potential ramifications after the COVID-19 public health emergency ends such as limiting telehealth, ending the continuous enrollment requirement in Medicaid, and decreasing regulatory flexibility that has allowed pharmacists to administer COVID-19 vaccines. 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. 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. 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. Doing so would decrease federal spending on Medicaid and allow states to remove ineligible people from the program, saving the government tens of billions of dollars. HHS Secretary Xavier Becerra last renewed the COVID public health emergency on Jan. 11, 2023. For a person who is no longer Medicaid-eligible under normal rules, Medicaid coverage can end as early as April 1, 2023. The state has to make a good-faith effort to find the person first. There are a number of waivers that ANA would like to become permanent. 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. During the PHE, Medicaid agencies have not disenrolled most members, even if someone's eligibility changed . An analysis of state Medicaid websites found that while a majority of states translate their online application landing page or PDF application into other languages, most only provide Spanish translations (Figure 7). The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. Brief What Will Happen to Medicaid Enrollees' Health Coverage after the Public Health Emergency . 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. We are decoupling the Medicaid continuous eligibility policy from the Public Health Emergency. 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. States are also required to report on transitions to separate CHIP programs and to Marketplace or Basic Health Program coverage (Figure 10). Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . Or maybe your circumstances have changed perhaps your income is the same but you have fewer people in your household and your income now puts you at a higher percentage of the poverty level. A PHE can be extended as many times as deemed necessary by the Secretary. 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. That emergency is set to end in May. (Prior to the pandemic, states had to recheck each enrollees eligibility at least once per year, and disenroll people who were no longer eligible. Fortunately, Medicaid was able to step in and provide health coverage when people lost their income. 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. 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. Enrollees who have moved may not receive important renewal and other notices, especially if they have not updated their contact information with the state Medicaid agency. 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. The Biden administration has extended the public health emergency (PHE) for 90 days, from October 18, 2021 through January 16, 2022. HHS has laid out some basic guidelines, and states have four general options in terms of how they handle the unwinding of the continuous coverage protocols and the return to regular eligibility redeterminations for the entire Medicaid population: If youre still eligible for Medicaid under your states rules, youll be able to keep your coverage. What does this mean for Medicaid? 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. By law, public health emergencies are declared in 90-day increments. Sharing updates regarding the end of public health emergency declarations and extensions by way of the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. . After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be significant. During the PHE, Medicaid enrollees automatically stayed enrolled in Medicaid and did not have to constantly keep proving eligibility. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. But the overall pace of Medicaid eligibility redeterminations and disenrollments will vary considerably from one state to another. Much of Medicare is in statute, and as a result the Administration has limited authority to expand telehealth absent Congressional action. 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. Total Medicaid/CHIP enrollment grew to 91.3 million in October 2022, an increase of 20.2 million or more than 28.5% from enrollment in February 2020 (Figure 1). 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. The Biden administration announced its intention to end the federal public health emergency on May 11, 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 Centers for Medicare & Medicaid Services (CMS) implemented several interim final rules during the PHE. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. In the second quarter, that will drop to 5 percentage points. There is normally quite a bit of turnover in the Medicaid program, with some people losing eligibility each month. This would have incentivized some states to act as quickly as possible to disenroll people from Medicaid. hb```+@(1IAcfK9[<6k`cts``NaPsg@uQVH(pGS 4)NtQlqV~T~(plUUv=@\8\:\4?LqB d Your email address will not be published. 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 . Required fields are marked *. 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. Some have described this as the single largest enrollment event since the Affordable Care Act. Many of these waivers and broad . Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. 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. Dont panic: Coverage is almost certainly available. 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. So, there is some ambiguity as to when payments will be required to resume. By preventing states from disenrolling people from coverage, the continuous enrollment provision has helped to preserve coverage during the pandemic. 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. Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. Opens in a new window. Total Medicaid/CHIP enrollment grew to 90.9 million in September 2022 . The impending termination of FFCRAs continuous coverage rules and return to business as usual for Medicaid can be a nerve-wracking prospect for some enrollees. The continuous coverage provision increased state spending for Medicaid, though KFF has estimated that the enhanced federal funding from a 6.2 percentage point increase in the federal match rate (FMAP) exceeded the higher state costs. The Congressional Budget Office assumes the public health emergency for Covid will expire in July barring another extension by the Biden administration. 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. The COVID-19 pandemic cast a spotlight on the importance of the various safety net systems that the U.S. has in place. Please provide your zip code to see plans in your area. Note: This brief was updated Feb. 22, 2023, to include more recent and additional data. NOTE: States may not elect a period longer than the Presidential or Secretarial emergency declaration . One note about the Childrens Health Insurance Program (CHIP): States that operate a separate CHIP were not required to suspend CHIP disenrollments during the pandemic. President Biden says the emergency order will expire May 11. Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). Medicaid enrollment increased by over 17 million from February 2020 to May 2022. Published: Feb 22, 2023. States can take action to minimize the number of people who become uninsured due to Medicaid eligibility redeterminations after the PHE. Medicaid eligibility redeterminations will resume in 2023. This article has also been updated to note that the American Rescue Plans subsidy enhancements have been extended by the Inflation Reduction Act. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. 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. CNN . Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). 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. Congress has extended the telehealth flexibility through the end of 2024, but it is unclear if it will be extended further or made permanent. including education, public health, justice, environment, equity, and, . 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. The resumption of eligibility redeterminations is no longer linked to end of public health emergency. 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. 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. 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. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 b1Y nact1X i"hi9!0 "@,f W1LL\vL1.ez,t_M8cp]4XfiFfm m2=sX1g`Vw? We do not sell insurance products, but this form will connect you with partners of healthinsurance.org who do sell insurance products. Now, Democrats are prepared to join them four people close to the negotiations tell POLITICO. 7.8 million enrollees by March 2023. 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. In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state PHE. Heres what enrollees need to know. The lack of certainty is weighing on states and Medicaid stakeholders. Democrats are on the record as being open to that, a Senate Republican aide told POLITICO. Were hopeful that states will work to make the redeterminations and renewals process as transparent, accurate, and simple as possible. Gov. 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 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. 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. CMS requires states to develop operational plans for how they will approach the unwinding process. That means that this will end on December 31 of this year. 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. CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment. Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work. (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). hb```k- 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. 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. Founded in 2005, CCF is devoted to improving the health of Americas children and families, particularly those with low and moderate incomes. A KFF analysis revealed that among people disenrolling from Medicaid, roughly two-thirds (65%) had a period of uninsurance in the year following dise0nrollment and only 26% enrolled in another source of coverage for the full year following disenrollment (Figure 12). 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 There are millions of people who became eligible for Medicaid at some point since March 2020, and are still enrolled in Medicaid even though they would not be determined eligible if they were to apply today. Lawmakers have struck an agreement to move the end of its Medicaid rules. She has written dozens of opinions and educational pieces about theAffordable Care Actfor healthinsurance.org. 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 . 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. 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. By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. Similarly, a survey of Marketplace assister programs found that assister programs were planning a variety of outreach efforts, such as public education events and targeted outreach in low-income communities, to raise consumer awareness about the end of the continuous enrollment provision (Figure 9). 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. Within six months Republican aide told POLITICO, HHS Secretary Xavier Becerra renewed. Times as deemed necessary by the Biden administration Becerra renewed the Covid public health emergency ( )! Federal and state Medicaid spending for 2022 and four people close to the negotiations tell POLITICO to.... 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