To fully assess the impact of the unwinding will require broader outcome measures, such as continuity of coverage across Medicaid, CHIP, Marketplace, and employer coverage, gaps in coverage over time, and increases in the number of the uninsured, data that will not be available in the short-term. But that was an uncertain and ever-changing date, as the PHE has continued to be extended. And if youre no longer eligible for Medicaid, youre almost certainly eligible for an employer-sponsored plan, Medicare, or a subsidized plan in the marketplace. On April 12, 2022, the Secretary of Health and Human Services (HHS), Xavier Becerra, announced the extension of the public health emergency (PHE) related to the Coronavirus Disease 2019 (COVID-19) pandemic. including education, public health, justice, environment, equity, and, . That emergency is set to end in May. Further, states must also comply with federal rules about conducting renewals. Together, these findings suggest that individuals face barriers moving from Medicaid to other coverage programs, including S-CHIP. Nursing school is expensive and as a result roughly of nursing students take out federal student loans to help pay for school. 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). Follow @meg_ammula on Twitter Yet Congress signaled change in the final days of 2022. Findings This cohort study of 4869 Latina patients with gestational (n = 2907) or preexisting diabetes (n . This is true regardless of whether youll qualify for the new low-income special enrollment period, since youll have a normal loss-of-coverage special enrollment period when your Medicaid ends, and you can take advantage of it right away. According to a survey of non-profit, safety net health plans that participate in Medicaid, states are partnering with these MCOs in multiple ways. CMS is ending the requirement that the supervising clinician be immediately available at the end of the calendar year where the PHE ends. Medicaid enrollment increased by over 17 million from February 2020 to May 2022. 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. 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. 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. The PHE will probably be extended through the first half of 2022, and further extension is possible. The Biden administration appears headed toward extending the COVID-19 public health emergency for another three months, allowing special powers and programs to continue past the midterm election. (PHE) ends. endstream endobj startxref 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. 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. 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. [Editors Note: Read the latest on the public health emergency Medicaid continuous coverage protectionhere.]. HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. 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 Contact Us, 2023 Center for Children & Families (CCF) of the Georgetown University Health Policy Institute, McCourt School of Public Policy, Georgetown University | 600 New Jersey Ave. NW | Washington, DC 20001 | 202.784.3138, Georgetown Center for Children and Families Homepage, Percent of Children Covered by Medicaid/CHIP by Congressional District, 2018, Percent of Adults Covered by Medicaid/CHIP by Congressional District, 2018, renewed the COVID-related public health emergency. 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. The proposed eligibility and enrollment rule aims to smooth transitions between Medicaid and CHIP by requiring the programs to accept eligibility determinations from the other program, to develop procedures for electronically transferring account information, and to provide combined notices. Verify that your information is correct and select Place My Order. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision. CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment. %PDF-1.7 % It can be allowed to expire at the end of the 90-day period or terminated early if deemed appropriate. Were hopeful that states will work to make the redeterminations and renewals process as transparent, accurate, and simple as possible. 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 COVID public health emergency (PHE) is expected to be extended again in January 2023, but the omnibus bill de-links the resumption of Medicaid eligibility redeterminations from the PHE, and allows states to start processing eligibility determinations as of April 1, 2023. Oral arguments on the program were argued before the Supreme Court on February 28, and a decision is expected this Term. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 ts noteworthy that the additional federal Medicaid funding that states have received is. Helping millions of Americans since 1994. 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. 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. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. 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. Find out how much financial help you may qualify for. Dig Deeper Medicaid Spending on. 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 . V,wfBt3 [ho The lack of certainty is weighing on states and Medicaid stakeholders. Moreover, research shows that when parents gained coverage under the Medicaid expansion, Medicaid participation among their eligible but unenrolled children also increased. The PHE is expected to continue until mid-May 2023. 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. What do these three possible scenarios mean for Medicaid if Congress does not take additional action as proposed in the Build Back Better Act (BBB)? If CMS determines a state is out of compliance with any applicable redetermination and reporting requirements, it can require the state to submit a corrective action plan and can require the state to suspend all or some terminations due to procedural reasons until the state takes appropriate corrective action. 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. Were providing certainty to states and giving them a gradual stream of funding and guardrail requirements that protect people. The non-partisan Congressional Budget Office assumes the public health emergency for Covid is set to expire in July. 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. Simplifying those transitions to reduce the barriers people face could help ensure people who are no longer eligible for Medicaid do not become uninsured. 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. That's at least in part due to 2020's Families First Coronavirus Response Act, which required state Medicaid programs to keep beneficiaries enrolled through the duration of the pandemic. This is something both Democratic and Republican states asked for so that the 90 million people enrolled in Medicaid can be given certainty and protected during this massive undertaking.. 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. That will resume in April 2023.). 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. The state has to make a good-faith effort to find the person first. 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. 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). The Biden administration has extended the Covid-19 public health emergency as a highly transmissible omicron subvariant stokes concern that the nation may face another wave of. 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. Would love your thoughts, please comment. The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. However, when states resume Medicaid disenrollments when the continuous enrollment provision ends, these coverage gains could be reversed. With respect to Medicare: We do not offer every plan available in your area. 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. The Biden administration on Friday extended the Covid-19 public health emergency for another three months. The end of the PHE will end this automatic enrollment and will require enrollees to prove eligibility. (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.). Starting April 1, 2023, states can resume Medicaid disenrollments. during which you can transition to Medicare without any late enrollment penalties. Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. For everyone enrolled in Medicaid as of March 31, 2023, states must initiate the renewal process no later than March 31, 2024. 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). . 2022-2023 Medicaid Managed Care Rate Development Guide. Can you appeal your states decision to disenroll you? 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. Its only a pay-for because youd be removing people from Medicaid, said Brian Blase, the president of the conservative Paragon Health institute and a former senior Senate Republican aide. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be . 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 Biden Administration announced on January 30 that the COVID-19 national public health emergency (PHE) will end on May 11, 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. 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. Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice . Some states suspended renewals as they implemented the continuous enrollment provision and made other COVID-related adjustments to operations. Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California. This 152-day extension then ends on October 9. 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. 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. 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. NOTE: States may not elect a period longer than the Presidential or Secretarial emergency declaration . Published: Feb 22, 2023. This article has also been updated to note that the American Rescue Plans subsidy enhancements have been extended by the Inflation Reduction Act. 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. March 31, 2023 is the last day that states have to maintain the continuous coverage rules that have been in place since March 2020. A 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. 3168 0 obj <> endobj The Biden administration extended the U.S. coronavirus public health emergency, now more than two years old, for another 90 days on Wednesday. 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. Democrats, in contrast, have been hesitant to tie the administrations hands as the virus continues to kill hundreds of people each day and a winter surge of several illnesses strains the countrys medical system. 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. forced a handful of successful Senate votes. A majority of states also indicated they were taking steps to update enrollee contact information and were planning to follow up with enrollees before terminating coverage. %%EOF 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. 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. For the most up-to-date news and . 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. What does this mean for Medicaid? Opens in a new window. 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