The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. The Biden Administration announced on January 30 that the COVID-19 national public health emergency (PHE) will end on May 11, 2023. . Much of Medicare is in statute, and as a result the Administration has limited authority to expand telehealth absent Congressional action. 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 Administration has stated that payments will resume either sixty days after the Supreme Court renders an opinion or June 30, whichever comes first. 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. This 152-day extension then ends on October 9. 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. 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. as proposed in the Build Back Better Act (BBB)? 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. Note: This brief was updated Feb. 22, 2023, to include more recent and additional data. 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. The question is: Can they get enough wins to take the political sting off allowing states to kick people off the rolls?. Ensuring accessibility of information, forms, and assistance will be key for preventing coverage losses and gaps among these individuals. 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. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. Medical personnel prepare to prone a Covid-19 patient at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles. | T p{YWY4,;U|p9 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023. 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 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. How many people will lose Medicaid coverage when the continuous coverage requirement ends? For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. 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. Congressional negotiators are set to unveil the text of the 2023 omnibus spending bill on Monday. The PHE has been in place since January 27, 2020, and renewed throughout the pandemic. endstream endobj startxref CMS requires states to develop operational plans for how they will approach the unwinding process. 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. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 Starting April 1, 2023, states can resume Medicaid disenrollments. 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. But thats no longer relevant in terms of the resumption of Medicaid eligibility redeterminations. Please provide your zip code to see plans in your area. The White House's Department of Health and Human Services (HHS) has extended the COVID-19 state of emergency. 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. CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment. She has written dozens of opinions and educational pieces about theAffordable Care Actfor healthinsurance.org. 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. Omnibus spending bill allows states to resume Medicaid eligibility redeterminations in April. During the PHE, Medicaid enrollees automatically stayed enrolled in Medicaid and did not have to constantly keep proving eligibility. 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 of January 10, 2023, CMS had approved a total of 158 waivers for 41 states (Figure 6). Founded in 2005, CCF is devoted to improving the health of Americas children and families, particularly those with low and moderate incomes. Written by Diane Archer. 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. the extra cost that states have incurred to cover the FFCRA-related enrollment growth. States that fail to comply with these reporting requirements face a reduction in federal medical assistance percentage (FMAP) of up to one percentage point for the quarter in which the requirements are not met. By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. Click Check Out Now. But if the answer is no, be prepared for a coverage termination notice at some point after the end of March 2023. And all states accepted the additional federal Medicaid funding. 01:02. Friday, February 24, 2023. 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. 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. 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. However, in many states, the share of renewals completed on an ex parte basis is low. You can share your story about the impact of the Public Health Emergency HERE. Preparing for the End of COVID-19: Return to Regular Renewals . 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. During the PHE, Medicaid agencies have not disenrolled most members, even if someone's eligibility changed . 4. These reporting requirements were part of a broad set of CMS guidance documents issued over the past several months. %%EOF In the third quarter, it will drop to 2.5 percentage points, and in the fourth quarter of 2023, states will receive 1.5 percentage points in additional federal Medicaid funding. (Be prepared to provide proof of your ongoing eligibility under your states Medicaid rules.). 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. The supervision requirements are also ending but are not based on the 152-day extension. Plus, if you funnel people into subsidized Obamacare plans, those are more expensive than Medicaid.. 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. The Biden administration has extended the public health emergency (PHE) for 90 days, from October 18, 2021 through January 16, 2022. 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. Medicaid and CHIP Services Information for People Receiving Services English Espaol In response to the COVID-19 pandemic, the federal government declared a public health emergency (PHE) and passed a law that allowed you to automatically keep your Medicaid coverage (continuous Medicaid). Lawmakers have struck an agreement to move the end of its Medicaid rules. . The public health emergency, first declared in January 2020 by the Trump administration, has been renewed every 90 days since the pandemic began. At that time, they will be required to conduct a full renewal based on current circumstances before disenrolling anyone. 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. 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. 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. 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. Further, states must also comply with federal rules about conducting renewals. The GOP-led Senate passed the proposal in the 2022 session, but it was killed in the House. The PA MEDI Helpline is available at 1-800-783-7067 from 8 a.m. to 5 p.m. Monday-Friday. On January 30, the Biden Administration announced May 11, 2023, as the targeted end date for the national public health emergency (PHE) declarations implemented during the COVID-19 pandemic. The main waivers are: The end of the PHE will also have an effect on the Medicaid program. 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. 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. But even if youre eligible for this ongoing special enrollment period, its still in your best interest to submit an application as soon as possible if you find out that youll be losing your Medicaid coverage. States can take action to minimize the number of people who become uninsured due to Medicaid eligibility redeterminations after the PHE. 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. You can unsubscribe anytime you want. CNN . The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the COVID-19 public health emergency through December 31, 2024. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. CMS is referring to the return to normal eligibility redeterminations and disenrollments as a Medicaid and CHIP unwinding.. This additional match will be slowly wound down through 2023 and the federal match will be returned to what it had been prior to the PHE in January 2024. 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). 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. 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. The latest extension will expire on April 16, 2022. Alternatively, some people who remain eligible may face barriers to maintaining coverage due to renewal processes and periodic eligibility checks. 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. 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. 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. 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). 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 Consolidated Appropriations Act, 2023 decouples the Medicaid continuous enrollment provision from the PHE and terminates this provision on March 31, 2023. uyx'tE!~YV.v.wDO @:Z98-PtinB*[Elrcr[b8B9NX5IR'[UC.ok"zf3itMAiP((ISh. Under the Consolidation Appropriations Act, 2023, the resumption of Medicaid disenrollments is no longer linked to the end of the COVID public health emergency. Some states suspended renewals as they implemented the continuous enrollment provision and made other COVID-related adjustments to operations. Moreover, research shows that when parents gained coverage under the Medicaid expansion, Medicaid participation among their eligible but unenrolled children also increased. 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. 0 Healthcare Dive reports that the majority of people with Medicaid do not know that their coverage could end when the public health emergency ends. [Editors Note: Read the latest on the public health emergency Medicaid continuous coverage protectionhere.]. That is now expected to happen in May 2023. 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). Twenty-eight states indicated they had settled on plan for prioritizing renewals while 41 said they planning to take 12 months to complete all renewals (the remaining 10 states said they planned to take less than 12 months to complete renewals or they had not yet decided on a timeframe). The main point to keep in mind is that the opportunity to transition to new coverage, from an employer, Medicare, or through the marketplace, is time-limited, although the unwinding SEP described above (announced in late January 2023) gives people significantly more flexibility in terms of being able to enroll in a plan through HealthCare.gov after losing Medicaid during the 16-month window that starts March 31, 2023. The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. for medical reasons related to the disaster or public health emergency, or who are otherwise absent from the state . 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. 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