Hurricane Katrina has displaced tens of thousands of people from their homes. Now residing in other areas, many have significant medical and mental health needs. The areas affected by the Hurricane are some of the poorest in the country and had high uninsured rates and a large number of residents enrolled in Medicaid prior to the disaster. Many displaced people are now jobless, resulting in even higher poverty rates and losses of employer-sponsored coverage. It has been estimated that some 200,000 people in Louisiana will lose employer coverage as companies eliminate staff and go out of business. Alabama, Mississippi, and Louisiana are all reeling from significant infrastructure and revenue losses and face an unprecedented rebuilding effort. Immediately following the disaster, states “hosting” evacuees sought to use Medicaid and SCHIP to support their health needs; however, four primary issues emerged. First, individuals eligible for Medicaid and SCHIP in their “Home” states needed to be eligible for and enroll in the “Host” state programs to receive assistance. Second, many individuals were newly uninsured and unable to pay for their health needs. Third, without Medicaid and SCHIP reimbursement, providers in the “Host” states could not be compensated for care provided to evacuees. Finally, because Medicaid and SCHIP are federal-state matching programs, “Host” states faced increased costs from enrolling evacuees. On September 16, 2005, the Administration released a new Medicaid waiver initiative designed to assist states in providing temporary Medicaid coverage to certain groups of evacuees. CMS developed a waiver template and provided expedited approval of these waivers. Under the waivers states may: (1) Provide up to five months of Medicaid or SCHIP coverage to certain, specified groups of evacuees. (2) Receive authorization for an “uncompensated care pool” that can be used reimburse providers for the costs of furnishing services to uninsured evacuees who do not qualify for Medicaid or SCHIP and to pay for services not covered under Medicaid or SCHIP. As of December 17, 2005, seventeen waivers (from 15 states and the District of Columbia and Puerto Rico) had been approved, including waivers for Alabama, Mississippi, and Louisiana.
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