Medicaid

According to the latest estimates from KFF, over 20 million Americans have now had their Medicaid or CHIP healthcare coverage terminated since the post-public health emergency "unwinding" process began one year ago:

At least 20,104,000 Medicaid enrollees have been disenrolled as of April 11, 2024, based on the most current data from all 50 states and the District of Columbia. Overall, 31% of people with a completed renewal were disenrolled in reporting states while 69%, or 43.6 million enrollees, had their coverage renewed (one reporting state does not include data on renewed enrollees). Due to varying lags for when states report data, the data reported here undercount the actual number of disenrollments to date.

via North Carolina Governor Roy Cooper:

Today, Governor Cooper announced that more than 400,000 North Carolinians now have access to health care through the state’s Medicaid expansion following record enrollment numbers and a coordinated campaign to enroll North Carolinians across the state.

“So many younger, working people desperately need affordable health insurance and Medicaid Expansion fills the bill for thousands of them and with people all the way through age 64,” said Governor Roy Cooper. “This milestone and the speed at which we’ve reached it shows just how lifechanging Medicaid expansion is for our state and we will continue to get more eligible North Carolinians enrolled.”

I didn't catch this press release a few days ago but it sounds like a pretty Big F*cking Deal, to use the words of President Biden:

via the Centers for Medicare & Medicaid Services (CMS):

The Biden-Harris Administration today unveiled a final rule that will protect and improve how millions of eligible people apply for, renew, and maintain health care coverage through Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). The Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes rule will remove red tape and barriers to enrollment, update and build on the Affordable Care Act’s (ACA’s) coverage protections and ensure that millions of Americans can get and keep their coverage. With this rule, millions of Americans will benefit from a modernized, less cumbersome enrollment process with reduced red tape, helping more people keep coverage. 

(Note: This was actually announced the day before CMS posted the December Medicaid Unwinding transition data.)

Via the Centers for Medicare & Medicaid Services (CMS):

HHS Extends Special Enrollment Period to Help People Transition to the Marketplaces, Issues New Resources for Partners, and Publishes Guidance Reinforcing Key Federal Requirements

via the Centers for Medicare & Medicaid Services (CMS):

  • In December 2023, 85,094,448 individuals were enrolled in Medicaid and CHIP, a decrease of 785,863 individuals (0.9%) from November 2023
    • 77,913,798 individuals were enrolled in Medicaid in December 2023, a decrease of 786,068 individuals (1.0%) from November 2023.
    • 7,180,650 individuals were enrolled in CHIP in December 2023, an increase of 205 individuals (0.0%) from November 2023.
  • As of December 2023, enrollment in Medicaid and CHIP has decreased by 8,773,558 individuals (9.3%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
    • Medicaid enrollment has decreased by 8,816,761 individuals (10.2%).
    • CHIP enrollment has increased by 43,203 individuals (0.6%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,992,937 individuals (32.4%) to 93,868,006.
    • Medicaid enrollment increased by 22,6350,766 individuals (35.3%).
    • CHIP enrollment increased by 342,171 individuals (5.0%).

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.

February 16th:

I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...

...As I noted, however, in all three [states] it's pretty likely they'll go with at least a partially privatized version as Arkansas has instead of a "clean" expansion of Medicaid proper.

Of course, as one Alabama-based advocate put it...

Mississippi better not beat us to expand.

— Jane Adams (@janeadamsid) February 16, 2024

Well, it looks like Ms. Adams may end up being disappointed...

BREAKING: The Mississippi House just passed Medicaid expansion by a 96-20 vote.
That's more than enough to overcome a veto from Gov. Tate Reeves.
It now heads to the Senate.

via the NJ Dept. of Banking & Insurance:

New Jersey Department of Banking and Insurance Acting Commissioner Justin Zimmerman today announced an expanded Special Enrollment Period for individuals who are no longer eligible for NJ FamilyCare and qualify for health insurance through Get Covered New Jersey, the state’s Official Health Insurance Marketplace. The expanded Special Enrollment Period will be available to anyone who lost NJ FamilyCare coverage due to resumption of eligibility reviews regardless of the date they lost coverage. Previously, individuals had 120 days to enroll after their NJ FamilyCare coverage ended.

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.

via the Centers for Medicare & Medicaid Services (CMS):

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced Utah’s extension of comprehensive coverage for postpartum individuals for a full 12 months through Medicaid and the Children’s Health Insurance Program (CHIP).

via the Centers for Medicare & Medicaid Services (CMS):

  • In November 2023, 85,815,827 individuals were enrolled in Medicaid and CHIP, a decrease of 1,503,283 individuals (1.7%) from October 2023.
    • 78,710,401 individuals were enrolled in Medicaid in November 2023, a decrease of 1,523,107 individuals (1.9%) from October 2023.
    • 7,105,426 individuals were enrolled in CHIP in November 2023, an increase of 19,824 individuals (0.3%) from October 2023.
  • As of November 2023, enrollment in Medicaid and CHIP has decreased by 8,034,913 individuals (8.6%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
    • Medicaid enrollment has decreased by 8,007,036 individuals (9.2%).
    • CHIP enrollment has decreased by 27,877 individuals (0.4%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,975,671 individuals (32.4%) to 93,850,740.
    • Medicaid enrollment increased by 22,637,644 individuals (35.3%).
      • CHIP enrollment increased by 338,027 individuals (5.0%).

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