Lastly, states are required to maintain up to date contact information and attempt to contact enrollees prior to disenrollment when mail is returned. Please provide your zip code to see plans in your area. People using this window can, If youre eligible for Medicare, youll have. Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work. If your state notifies you that youre no longer eligible for Medicaid and you believe that you are still eligible, you can appeal the states decision. instructed providers requesting an extension to specify, as part of their extension request, their plan for finishing their demonstrations of compliance by December 30, 2022. 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 COVID-19 pandemic cast a spotlight on the importance of the various safety net systems that the U.S. has in place. Friday, February 24, 2023. 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. Browse plans and costs with an easy, anonymous online tool. Fortunately, Medicaid was able to step in and provide health coverage when people lost their income. the extra cost that states have incurred to cover the FFCRA-related enrollment growth. States can also consider sharing information on consumers losing Medicaid who may be eligible for Marketplace coverage with Marketplace assister programs; however, in a recent survey, few assister programs (29%) expected states to provide this information although nearly half were unsure of their states plans. 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 supervision requirements are also ending but are not based on the 152-day extension. EDITORS NOTE: This article was first posted in March 2022 but has been updated to reflect the passage of the Consolidated Appropriations Act, 2023 (the omnibus spending bill). 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.. Please contact Medicare.gov or 1800 MEDICARE to get information on all of your options. . Both . 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. 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 . A MACPAC analysis examined coverage transitions for adults and children who were disenrolled from Medicaid or separate CHIP (S-CHIP) and found that very few adults or children transitioned to federal Marketplace coverage, only 21% of children transitioned from Medicaid to S-CHIP, while 47% of children transitioned from S-CHIP to Medicaid (Figure 11). 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?. On January 5, 2023, CMS released an Informational Bulletin that included timelines for states to submit a renewal redistribution plan (discussed above), system readiness plans and results, and baseline unwinding data based on when states plan to begin renewals. But the overall pace of Medicaid eligibility redeterminations and disenrollments will vary considerably from one state to another. 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. 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. With respect to Medicare: We do not offer every plan available in your area. The Biden Administration announced on January 30 that the COVID-19 national public health emergency (PHE) will end on May 11, 2023. . CMS is ending the requirement that the supervising clinician be immediately available at the end of the calendar year where the PHE ends. Under the prior rules, that would have meant that Medicaid eligibility redeterminations (and terminations) could have resumed as of June 2023. HHS projects that approximately 15 million people will lose eligibility for Medicaid once the normal eligibility redetermination process resumes. Brief What Will Happen to Medicaid Enrollees' Health Coverage after the Public Health Emergency . %PDF-1.6 % This article has also been updated to note that the American Rescue Plans subsidy enhancements have been extended by the Inflation Reduction Act. 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. The PA MEDI Helpline is available at 1-800-783-7067 from 8 a.m. to 5 p.m. Monday-Friday. US Department of Health and Human Services Secretary Xavier Becerra . The law also prohibits states from disenrolling a person simply based on undelivered mail. 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. 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). Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. There are a number of waivers that ANA would like to become permanent. 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 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. 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). 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. That emergency is set to end in May. But that was an uncertain and ever-changing date, as the PHE has continued to be extended. 541 0 obj <>stream 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). 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. 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 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. Low-income enrollees will able to enroll in ACA coverage during a special enrollment period. Nearly every state has been conducting some type of outreach campaign around this, asking Medicaid enrollees to be sure that the state has their current contact information on file. as proposed in the Build Back Better Act (BBB)? during which you can transition to Medicare without any late enrollment penalties. 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. CMS requires states to develop operational plans for how they will approach the unwinding process. Some of these waivers had previously expired, but ANA is still advocating to change the law and make them permanently part of the Medicare program. By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. 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. center between 2018 and 2022 . 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. 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. President Biden says the emergency order will expire May 11. The purpose of this bulletin is to inform providers that the federal public health emergency (PHE) was extended on January 14, 2022, and will now last until April 16, 2022. 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. However, the Administrations superseding debt forgiveness program is still pending in the courts. 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. The move will maintain a range of health benefits . (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.). Democrats are on the record as being open to that, a Senate Republican aide told POLITICO. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. What does this mean for Medicaid? Were providing certainty to states and giving them a gradual stream of funding and guardrail requirements that protect people. Prescribed Pediatric Extended Care services by 15% effective October 1, 2022 through the end of the public health emergency. The lack of certainty is weighing on states and Medicaid stakeholders. The temporary loss of Medicaid coverage in which enrollees disenroll and then re-enroll within a short period of time, often referred to as churn, occurs for a several reasons. By law, public health emergencies are declared in 90-day increments. What should you do if you currently have Medicaid coverage? 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. One mitigation strategy insurers and health officials pushed for: a tweak to the Telephone Consumer Protection Act that would allow health plans and state agencies to call and text residents set to lose Medicaid to walk them through their options. Share this: . And some states that also offer additional state-funded subsidies allow people with higher incomes to enroll year-round. 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. hbbd```b``>"IOjfo H80 f3Or e: ,`2DI[ v&,HK I+@ R Share on Facebook. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision. However, in many states, the share of renewals completed on an ex parte basis is low. 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. 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. Click Check Out Now. 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. 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. Importantly, the legislation requires these reports be made publicly available. 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. 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision, 10 Things to Know About Medicaid Managed Care, FAQs on Health Spending, the Federal Budget, and Budget Enforcement Tools, Health Insurer Financial Performance in 2021. 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. An Informational Bulletin (CIB) posted on January 5, 2023 included timelines for states to submit a renewal redistribution plan. 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. The GOP-led Senate passed the proposal in the 2022 session, but it was killed in the House. uyx'tE!~YV.v.wDO @:Z98-PtinB*[Elrcr[b8B9NX5IR'[UC.ok"zf3itMAiP((ISh. endstream endobj startxref But the Consolidated Appropriations Act, 2023 ensures that states continue to receive at least some additional federal Medicaid funding throughout 2023. | T p{YWY4,;U|p9 forced a handful of successful Senate votes. The PHE is expected to continue until mid-May 2023. Under normal circumstances, they would have lost their Medicaid eligibility upon turning 65, as the, 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. And all states accepted the additional federal Medicaid funding. For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. On March 18, 2020, the Families First Coronavirus Response Act was signed into law. You can unsubscribe anytime you want. 3179 0 obj <>/Filter/FlateDecode/ID[<20F5AF77DB63DC49B2341D6107722670>]/Index[3168 23]/Info 3167 0 R/Length 69/Prev 482993/Root 3169 0 R/Size 3191/Type/XRef/W[1 2 1]>>stream Note: This brief was updated Feb. 22, 2023, to include more recent and additional data. 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. Can you appeal your states decision to disenroll you? The public health emergency, first declared in January 2020 by the Trump administration, has been renewed every 90 days since the pandemic began. Republicans pushing for the deal have also been reminding Democrats that their original Build Back Better legislative package which ultimately became the Inflation Reduction Act and passed this year after being significantly whittled down included a wind-down of the public health emergency as a pay-for. Dont panic: Coverage is almost certainly available. the federal government declared a public health emergency (PHE). Earlier today, HHS Secretary Becerra renewed the COVID-related public health emergency (PHE). Tate Reeves, after months of resistance, asks lawmakers to pass postpartum Medicaid extension by Bobby Harrison February 26, 2023 February 26, 2023. 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. For the first quarter of 2023, states will continue to get the 6.2 percentage point boost that theyve been receiving throughout the pandemic. Section 319 of the Public Health Service Act gives the federal HHS Secretary the authority to make such a declaration when a severe disease . But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. 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. 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). 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 . (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.). A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994. 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. (Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. Heres what enrollees need to know. Findings This cohort study of 4869 Latina patients with gestational (n = 2907) or preexisting diabetes (n . So where does this leave the continuous enrollment requirement? Its clear their support and openness to it is contingent on reinvesting the savings back into Medicaid in a permanent way. 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. The end of the PHE will end this automatic enrollment and will require enrollees to prove eligibility. Medicaid enrollment increased by over 17 million from February 2020 to May 2022. That is now expected to happen in May 2023. Depending on when such legislation might be taken up, Congress will likely be pressured to push the unwinding out beyond April 1, 2022. Under the ACA, states must seek to complete administrative (or ex parte) renewals by verifying ongoing eligibility through available data sources, such as state wage databases, before sending a renewal form or requesting documentation from an enrollee. 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. Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. 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. (PHE) ends. Because of specific Congressional action many of the telehealth flexibilities authorized under the PHE will continue through the end of 2024. 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