State officials want more time and money to restore Medicaid


On Thursday, two states called for federal funding and advance notice of the end of the COVID-19 public health emergency so they can plan for recovery Medicaid Eligibility Redetermination After a long pause.

The end of the public health emergency will create a A lot of work For state Medicaid agencies and related departments.Agencies suffer the same labor shortage Utah Department of Health Director of Eligibility Policy Jeff Nelson and Oregon Department of Health Director of Health Policy and Analysis Jeremy Vandehey at Medicaid and CHIP Payment and Access Committee meetings.

During the COVID-19 public health emergency, states have had to maintain their Medicaid rosters in order to receive more federal Medicaid funding.As a result, Medicaid enrollment reached record highs to last year.

That requirement will end with the public health emergency, and federal officials have said they will give at least 60 days’ notice before the designation expires. The state of public health emergency is currently extended until April.

But Nelson said states could benefit from early notice. The federal government’s reminder will allow agencies to ramp up pre-determined activities, which could make the actual renewal smoother.

A provision in the Build Back Better Act, which passed the House, but it seems die in the senate, will delink the end of the ongoing registration requirement from the public health emergency. Under the rule, additional funding will be phased out and states must redefine starting in April 2022, regardless of the status of the pandemic.

“It’s great that the public health emergency has been extended,” Vandehey said. “However, if it’s going to be extended again, we really need to know what it’s going to look like.”

The Trump administration issued guidance in December 2020 that states would resume their regular insurance renewal processes within six months of the end of the public health emergency.Biden administration later changed guidelines, giving states a full year to deal with the backlog. States are grateful for the extra six months, but it’s still not enough, Nielsen said.

Further complicating matters, the federal funding that comes with maintaining the Medicaid roster during the pandemic can only last until the quarter that the public health emergency ends.

“We’re not losing that, we’re not getting paid for that time,” Nielsen said, adding that Utah officials have proposed requiring the redetermination to be done in a shorter time than federal guidance allows, although the idea doesn’t Adopted by the state at this point.

Brian Burwell, vice president of health care policy and research at technology consulting firm Ventech Solutions, said he wants more information on states’ finances as they demand more Medicaid funding. Some states are in the red, he said, but he is working with a state he did not name that has an $8 billion surplus in fiscal 2022.

But Commissioner Darlene Gordon, a health care consultant and former Tennessee Medicaid director, said states are asking for funds to return to normal operations after a federal mandate led to major changes to the system, which seems like a reasonable request.

State officials and beneficiary advocates also remain concerned about the number of people who could lose health insurance when the reset begins. Experts expect many eligible people to lose coverage due to administrative negligence.

Melissa McChesney, health policy advisor to the civil rights group UnidosUS, told MACPAC that the Centers for Medicare and Medicaid Services requirements need to be better enforced to help minimize the number of people who end up uninsured.

Vandehey added that forecasters in Oregon are predicting that about 300,000 people will lose coverage during the re-identification period following the public health emergency. He expects many to return to Medicaid at some point in the future.

Because of this, Oregon is looking for ways to permanently change policy to stabilize coverage, such as implementing basic health plan This provides coverage for individuals whose income may fluctuate around Medicaid eligibility levels and redetermines every two years rather than every year, he said.

Medicaid advisors agreed at the end of the meeting that reinstatement of eligibility was an important topic to watch, but did not plan to do anything about it at this time.



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