State Medicaid agencies and State-based Marketplaces - collectively, “States” - faced challenges in maintaining key enrollment functions as a result of a rapidly changing landscape during the COVID-19 PHE. States could no longer rely on existing outreach practices because patterns of work and life shifted with the closure of workplaces and other community settings. COVID-19 also exacerbated ongoing staffing shortages. Further, gaps in demographic data about applicants and enrollees limited States’ ability to identify disparities and to support equitable access to enhanced coverage. At the same time, States faced a surge in demand for coverage and had to align their enrollment and program operations with new Medicaid and Marketplace requirements and eligibility options promulgated in response to COVID-19.
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