Medicaid Unwinding

Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.

However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.

As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.

Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.

However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.

As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.

Last fall Oregon moved to the next step on their Basic Health Plan program (via Oregon Public Broadcasting):

Oregon becomes 3rd in nation to seek federal approval for a basic health program

A group of volunteer advisors to the Oregon Health Authority has voted Tuesday to make the state the third in the nation to seek federal approval for a basic health program.

...The Oregon Health Policy Board voted unanimously to approve Oregon’s blueprint application. It was the last step in a lengthy policy-making process needed for state approval of the plan after a task force last year recommended moving forward with it.

Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.

However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.

As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.

via Covered California:

Covered California announced today that more than 158,000 Californians remained covered through the Medi-Cal to Covered California enrollment program over the past year.

Beginning in April 2023, following the end of the federal continuous coverage requirement put in place during the COVID-19 pandemic, Medi-Cal resumed its renewal process by redetermining eligibility for over 15 million of its members. In May 2023, Covered California and the Department of Health Care Services (DHCS), which administers California’s Medi-Cal program, launched the Medi-Cal to Covered California enrollment program.

Under the program, Covered California automatically enrolls individuals in one of its low-cost health plans when they lose Medi-Cal coverage and gain eligibility for financial help through Covered California. Through early June of 2024, the program has helped 158,100 Californians remain insured.

Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.

However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.

As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.

OK, I'm back from the Doctors for America conference! I'll be posting a write-up about that soon, but in the meantime I have a backlog of healthcare policy developments to catch up on...

Last fall Oregon moved to the next step on their Basic Health Plan program (via Oregon Public Broadcasting):

Oregon becomes 3rd in nation to seek federal approval for a basic health program

A group of volunteer advisors to the Oregon Health Authority has voted Tuesday to make the state the third in the nation to seek federal approval for a basic health program.

...The Oregon Health Policy Board voted unanimously to approve Oregon’s blueprint application. It was the last step in a lengthy policy-making process needed for state approval of the plan after a task force last year recommended moving forward with it.

Via the U.S. Health & Human Services Dept (HHS):

Today, U.S. Health and Human Services Secretary Xavier Becerra released the following statement after the Centers for Disease Control and Prevention (CDC) released new data - PDF showing the uninsurance rate holding steady at 7.7 percent:

“Under President Biden’s leadership more people have health coverage than under any previous president. Even more encouraging, the data released today does not reflect the record-breaking open enrollment period that saw over 21 million people sign up for insurance. The Biden-Harris Administration will redouble our efforts to make sure tax breaks for working families stay in place so that every single person in America can go to the doctor and afford the care that will keep them and their families healthy.”

via the NJ Dept. of Banking & Insurance:

TRENTON — New Jersey Department of Banking and Insurance Acting Commissioner Justin Zimmerman today announced the department will continue and extend a previously announced Special Enrollment Period (SEP) to make it easier for qualified individuals who are no longer eligible for NJ FamilyCare coverage to enroll with Get Covered New Jersey.

As required by federal law, the Department of Human Services restarted eligibility reviews for NJ FamilyCare on April 1, 2023. Those who no longer qualify for NJ FamilyCare because their income is too high may be eligible to obtain health coverage through Get Covered New Jersey and may be able to get help paying for premiums.

The end date of this SEP will be extended from July 31, 2024, to November 30, 2024, which will help more individuals leaving NJ FamilyCare to find quality, affordable health insurance through the start of the next Open Enrollment Period. Any eligible consumer who attests to losing NJ FamilyCare (Medicaid/CHIP) coverage between that same time period will be eligible for the SEP.

A month or so ago I noted that as ugly as the massive number of Americans who've had their Medicaid or CHIP coverage terminated is (nearly 22 million people as of last week, via KFF), there's some important mitigating factors to keep in mind (updated w/latest data):

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