Preparing for the biggest coverage event since the Affordable Care Act: perspectives from state health officials on the end of Medicaid’s continuous coverage requirement
- Collection:
- Health Policy and Services Research
- Author(s):
- Corlette, Sabrina, author Blumberg, Linda J., author Houston, Megan, author Wengle, Erik, author
- Contributor(s):
- Robert Wood Johnson Foundation, issuing body. Urban Institute, issuing body.
- Publication:
- Washington, DC : Urban Institute, March 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Financing, Government -- economics Health Equity -- economics Health Policy Insurance, Health -- statistics & numerical data Medicaid -- organization & administration Medically Uninsured -- statistics & numerical data Social Mobility United States
- Genre(s):
- Technical Report
- Abstract:
- The United States government declared a public health emergency (PHE) on January 31, 2020, and has extended it eight times since then.1 However, the government is expected to lift the PHE at some point in 2022. Allowing the PHE to expire represents more than the symbolic end of the pandemic; it will mean the termination of numerous federal policies that have had far-reaching effects across our health care system. One of those policies is the Medicaid continuous coverage requirement; it requires that state Medicaid agencies refrain from disenrolling people or tightening eligibility requirements during the PHE in exchange for enhanced federal Medicaid funding. Once the PHE ends, the requirement will end and states will begin reassessing eligibility, resulting in a projected 13 to 16 million people being disenrolled from Medicaid (Buettgens and Green 2022). However, many of these people—an estimated one-third—could be eligible for a subsidized Marketplace health plan. Helping several million people make the transition from Medicaid coverage to a Marketplace plan in 2022 will be an unprecedented challenge for state Medicaid and Marketplace officials. Many people have changed addresses since they first signed up for Medicaid, making it difficult for Medicaid agency staff to communicate with enrollees about eligibility redetermination. And some people will likely find applying for premium tax credits and selecting a Marketplace plan daunting. At the same time, many Medicaid agencies may face pressure to process eligibility determinations quickly to reduce states’ fiscal obligations when the federal share of Medicaid costs returns to traditional levels. The uncertainty over when the federal government will end the PHE is also creating challenges for state officials trying to plan for the large number of redeterminations that will be needed. If transitions from Medicaid to the Marketplace are not executed well, many of the millions of people eligible for subsidized Marketplace coverage could become uninsured. However, states that operate their own Marketplaces could be better positioned to help people successfully navigate this process, because they have significant autonomy and flexibility over their eligibility and enrollment systems, communications, and consumer assistance efforts. This brief examines preparations for the end of the PHE in 11 states with state-based Marketplaces (SBMs). We attempt to identify major challenges the state officials are facing and best practices for keeping people in coverage that could be adopted by the federally facilitated Marketplace and SBMs.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Extent:
- 1 online resource (1 PDF file (18 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918486681806676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918486681806676