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. Section 319 of the Public Health Service Act gives the federal HHS Secretary the authority to make such a declaration when a severe disease . Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. That is now expected to happen in May 2023. Also fueling Democrats shift: pressure from state health officials who have been lobbying Congress to give them a set date when their Covid posture will formally end after years of last-minute extensions from the White House. Any information we provide is limited to those plans we do offer in your area. 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. Without other action, states can start disenrolling people beginning May 1, 2022. 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 Biden administration announced its intention to end the federal public health emergency on May 11, 2023. 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. center between 2018 and 2022 . 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. 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. 0 For enrollment reporting, states will provide baseline data at the start of the unwinding period related to applications, enrollment, estimated timeframe for completing initiated renewals, and fair hearings, and then states will submit monthly reports that will be used to monitor these metrics throughout the unwinding period (Figure 10). Current emergencies 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. 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. 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. Verify that your information is correct and select Place My Order. (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.). People who can't access the website or who . Congress has extended the telehealth flexibility through the end of 2024, but it is unclear if it will be extended further or made permanent. As a result, in order for these waivers to continue, Congress must act and pass legislation making these waivers permanent. While nearly all states accept information by mail and in person, slightly fewer provide options for individuals to submit information over the phone (39 states) or through online accounts (41 states). Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). Home > Blog > Medicaid eligibility redeterminations will resume in 2023. 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. It can be allowed to expire at the end of the 90-day period or terminated early if deemed appropriate. The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. 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. Helping millions of Americans since 1994. Dont panic, but also dont delay, as your opportunity to enroll in new coverage will likely be time-limited. And some states that also offer additional state-funded subsidies allow people with higher incomes to enroll year-round. Nursing school is expensive and as a result roughly of nursing students take out federal student loans to help pay for school. 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). As of January 10, 2023, CMS had approved a total of 158 waivers for 41 states (Figure 6). Total Medicaid/CHIP enrollment grew to 90.9 million in September 2022 . With respect to Medicare: We do not offer every plan available in your area. Note: This brief was updated Feb. 22, 2023, to include more recent and additional data. 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. 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. 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. The latest extension will expire on April 16, 2022. 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 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. CMS requires states to develop operational plans for how they will approach the unwinding process. 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. The PHE is expected to continue until mid-May 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. (Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). 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.. 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. The move will maintain a range of health benefits . Findings This cohort study of 4869 Latina patients with gestational (n = 2907) or preexisting diabetes (n . 3. 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. 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. 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. But that was an uncertain and ever-changing date, as the PHE has continued to be extended. hbbd``b`$ = $: " Ms ]@B#F_ E+ 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. 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. 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). Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work. 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. 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. The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. The most recent draft of the BBB would have begun to phase out the enhanced FMAP in the second and third quarters of the year (April September 2022) and, if it becomes law as written, states would be allowed to restart renewals as of April 1st. 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. The Biden administration has extended the public health emergency (PHE) for 90 days, from October 18, 2021 through January 16, 2022. The state has to make a good-faith effort to find the person first. 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. Omnibus spending bill allows states to resume Medicaid eligibility redeterminations in April. 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. 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 number of states reporting they complete more than 50% of renewals using ex parte processes for non-MAGI groups (people whose eligibility is based on being over age 65 or having a disability) is even lower at 6. Free or nearly free coverage will be available in the marketplace for people eligible for this special enrollment period (this is a result of the American Rescue Plans subsidy enhancements). Medicaid enrollees should pay close attention to redetermination notices that they may receive once normal eligibility redeterminations resume. 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. And yet, many states have indicated they need more not less lead time. as proposed in the Build Back Better Act (BBB)? Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. 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 . 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. Louise Norrisis anindividual health insurancebroker who has been writing about health insurance and health reform since 2006. Amid tense arguments about how to spend the savings from the expedited end to the Medicaid portion of the PHE, lawmakers have also struggled over whether and how to set up guardrails to protect people who make slightly too much to qualify for Medicaid from being left without a private health insurance plan they can afford in 2023. Oral arguments on the program were argued before the Supreme Court on February 28, and a decision is expected this Term. (PHE) ends. 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). [Editors Note: Read the latest on the public health emergency Medicaid continuous coverage protectionhere.]. 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. For the most up-to-date news and . This policy update will examine several of the health-related COVID-19 Federal Emergency Declarations and which flexibilities will end in May. 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. Congressional negotiators are set to unveil the text of the 2023 omnibus spending bill on Monday. For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. 01:02. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. Fortunately, Medicaid was able to step in and provide health coverage when people lost their income. 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. During the PHE, Medicaid enrollees automatically stayed enrolled in Medicaid and did not have to constantly keep proving eligibility. An Informational Bulletin (CIB) posted on January 5, 2023 included timelines for states to submit a renewal redistribution plan. Together, these findings suggest that individuals face barriers moving from Medicaid to other coverage programs, including S-CHIP. hbbd```b``>"IOjfo H80 f3Or e: ,`2DI[ v&,HK I+@ R . There are a number of waivers that ANA would like to become permanent. 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 Administration has stated that payments will resume either sixty days after the Supreme Court renders an opinion or June 30, whichever comes first. Opens in a new window. By preventing states from disenrolling people from coverage, the continuous enrollment provision has helped to preserve coverage during the pandemic. The COVID SEP ended in most states. 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. Key Points. endstream endobj startxref HHS projects that nearly 8% of current Medicaid enrollees will lose their coverage despite continuing to be eligible once eligibility redeterminations resume. That emergency is set to end in May. This article has also been updated to note that the American Rescue Plans subsidy enhancements have been extended by the Inflation Reduction Act. Lawmakers have struck an agreement to move the end of its Medicaid rules. 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. 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. The public health emergency expanded Medicaid coverage eligibility - now that expansion may be going away. 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. 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. 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. This enrollment growth more than 27% in a little over two and a half years was initially tied to the widespread job and income losses that affected millions of Americans early in the COVID pandemic. The Consolidated Appropriations Act, 2023 decouples the Medicaid continuous enrollment provision from the PHE and terminates this provision on March 31, 2023. The Biden Administration announced on January 30 that the COVID-19 national public health emergency (PHE) will end on May 11, 2023. . At that time, they will be required to conduct a full renewal based on current circumstances before disenrolling anyone. Save my name, email, and website in this browser for the next time I comment. But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. 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. The powers activated by the emergency. For the first quarter of 2023, states will continue to get the 6.2 percentage point boost that theyve been receiving throughout the pandemic. The question is: Can they get enough wins to take the political sting off allowing states to kick people off the rolls?. 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. In some states, it will be the most significant enrollment action in the 50+ year history of 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. Medical personnel prepare to prone a Covid-19 patient at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles. No one thought the public health emergency would stay forever. 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. 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. 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. Medicaid rules. ) will likely be time-limited. ] to unveil the text of the COVID-19. Allowed to expire at the end of its Medicaid rules. ) updated Feb. 22, 2023 decouples Medicaid... At the end of its Medicaid rules. ) the COVID-related public health emergency Medicaid!, ` 2DI [ v &, HK I+ @ R boost that theyve been receiving the. 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