Medicaid/CHIP

After the conclusion of the COVID-19 Public Health Emergency, states began unwinding continuous coverage of Medicaid and CHIP. Removing ineligible children is now paused through the end of 2024 due to a 12-month continuous eligibility requirement for children on Medicaid and CHIP that Congress included in the Consolidated Appropriations Act. CMS is urging states to “redouble their efforts to implement policies and operational processes, conduct enhanced outreach, adopt all available waivers and flexibilities, and monitor data to ensure children who remain eligible for Medicaid and CHIP do not lose coverage.”

After reviewing enrollment data through March 2023, Department of Health and Human Services (HHS) Secretary Xavier Becerra is pressuring states that have the highest child disenrollment rates by number and percentage to adopt “additional federal strategies and flexibilities…[that]…prevent children and their families from losing coverage due to red tape.” Those states include Arkansas, Florida, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota, and Texas. HHS and CMS claim these nine states account for about 60 percent of the decline in children’s Medicaid and CHIP enrollment. The secretary called on the states to do the following:

• Adopt federal flexibilities and strategies developed to make renewals easier for children and families;

• Remove barriers, such as CHIP enrollment fees and premiums, that make it harder for children to transition to CHIP coverage if they are no longer eligible for Medicaid;

• Reach additional families by reducing call center wait times and partnering with pediatric providers, managed care plans, schools, and community organizations; and

• Expand their Medicaid programs, if states have not done so already.

The guidance document lays out various “tools” and additional flexibilities that states can adopt. It also includes a list of additional data and metrics states are encouraged to collect and report.