The Biden administration extended the U.S. coronavirus public health emergency, now more than two years old, for another 90 days on Wednesday. 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. 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. 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. 541 0 obj <>stream 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. Additionally, the federal government had offered an additional 6.2% match for states who met maintenance of effort criteria during the PHE. By preventing states from disenrolling people from coverage, the continuous enrollment provision has helped to preserve coverage during the pandemic. States will be eligible for the phase-down of the enhanced FMAP (6.2 percentage points through March 2023; 5 percentage points through June 2023; 2.5 percentage points through September 2023 and 1.5 percentage points through December 2023) if they comply with certain rules. 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). 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 What does this mean for Medicaid? By law, public health emergencies are declared in 90-day increments. CMS is ending the requirement that the supervising clinician be immediately available at the end of the calendar year where the PHE ends. CMS is releasing the 2022-2023 Medicaid Managed Care Rate Development Guide for states to use when setting rates with respect to any managed care program subject to federal actuarial soundness requirements during rating periods starting between July 1, 2022 and June 30, 2023. including education, public health, justice, environment, equity, and, . Dig Deeper Medicaid Spending on. 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. About 4.2% were disenrolled and then re-enrolled within three months and 6.9% within six months. Much of Medicare is in statute, and as a result the Administration has limited authority to expand telehealth absent Congressional action. 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. 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. Prescribed Pediatric Extended Care services by 15% effective October 1, 2022 through the end of the public health emergency. 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. Congressional negotiators are set to unveil the text of the 2023 omnibus spending bill on Monday. States are also required to report on transitions to separate CHIP programs and to Marketplace or Basic Health Program coverage (Figure 10). Dont panic: Coverage is almost certainly available. 1. prepare for the eventual end of the COVID-19 public health emergency (PHE), including a State Health Official Letter, Promoting Continuity For a person who is no longer Medicaid-eligible under normal rules, Medicaid coverage can end as early as April 1, 2023. 01:02. While the number of Medicaid enrollees who may be disenrolled during the unwinding period is highly uncertain, it is estimated that millions will lose coverage. For additional resources about the end of the PHE, you can visit the websites below: https://www.cms.gov/files/document/what-do-i-need-know-cms-waivers-flexibilities-and-transition-forward-covid-19-public-health.pdf, https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html, Your email address will not be published. | T p{YWY4,;U|p9 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. PA MEDI Counselors are specially trained to answer your questions and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance. HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. But if the answer is no, be prepared for a coverage termination notice at some point after the end of March 2023. 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. 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. This window, If you do not have access to an employer-sponsored health plan, you can apply for a premium tax credit (subsidy) to offset the cost of coverage in the, The subsidies that are currently available in the marketplace are particularly generous, thanks to the, If youre in a state that hasnt expanded Medicaid under the ACA and your income is below the poverty level, you may find yourself in the. 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. 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 main waivers are: The end of the PHE will also have an effect on the Medicaid program. Heres what enrollees need to know. Of the 42 states processing ex parte renewals for MAGI groups (people whose eligibility is based on modified adjusted gross income), only 11 states report completing 50% or more of renewals using ex parte processes. That is now expected to happen in May 2023. 2716, the Consolidated . 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. One of the benefits of this law is it allowed the State of Connecticut to extend Medicaid and CHIP ("HUSKY Health") coverage in response to the coronavirus pandemic. However, if the guardrails are too flimsy or non-existent, states could see a surge in their uninsured populations right as government Covid funding runs dry, and individuals will have to depend on health plans to cover tests, vaccines and therapeutics for the virus. %%EOF Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. A survey of health centers conducted in late 2021 found that nearly 50% of responding health centers reported they have or plan to reach out to their Medicaid patients with reminders to renew their coverage and to schedule appointments to assist them with renewing coverage. The law also prohibits states from disenrolling a person simply based on undelivered mail. The Administration has stated that payments will resume either sixty days after the Supreme Court renders an opinion or June 30, whichever comes first. Click Check Out Now. 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). 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. What are your options if youre no longer eligible for Medicaid? 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. Read about your data and privacy. For the most up-to-date news and . The current PHE ends January 16, 2022, so a 90-day extension takes us to April 16, 2022. But enrollment has trended upward throughout the pandemic, without the normal disenrollments that previously stemmed from the regular Medicaid eligibility redetermination process. 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. 3168 0 obj <> endobj 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. Published: Feb 22, 2023. 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. Its understandable that a primary goal of the redetermination process is to ensure that these individuals transition to other coverage, either from an employer or through the exchange/marketplace. You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. 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. To reduce the administrative burden on states, CMS announced the availability of temporary waivers through Section 1902(e)(14)(A) of the Social Security Act. Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. CNN . By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. 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. There are a number of waivers that ANA would like to become permanent. 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. We are decoupling the Medicaid continuous eligibility policy from the Public Health Emergency. Dont panic, but also dont delay, as your opportunity to enroll in new coverage will likely be time-limited. 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