AHIP helms coalition to avoid Medicaid redetermination coverage lapses

Photo: Marko Geber/Getty Images

A new coalition fronted by insurer group AHIP is pushing to avoid lapses in coverage for people who may be dropped from the Medicaid program once states restart redeterminations.

As states begin the process of redetermining which people are still eligible for the program, an Urban Institute report found that roughly 18 million people could lose access to Medicaid coverage.

That's part of what spurred AHIP to helm the Connecting to Coverage Coalition, which aims to be a single source of trusted information about the Medicaid redetermination process.

The CCC will also work to convene stakeholders to support information sharing, build on best practices, and develop solutions to ensure Americans are able to enroll in coverage, said AHIP. 

The group added CCC will support a "smooth transition" back to normal Medicaid eligibility during the redetermination process, connect Americans to resources, and help them connect to coverage through other available health insurance, such as individual market or ACA marketplace coverage, employer-provided coverage, or separate coverage under the Children's Health Insurance Program.

Other founding members of the CCC include American Cancer Society Cancer Action Network, The Arc of the United States, Cystic Fibrosis Foundation, Cancer Support Community, Mental Health America, Catholic Health Association of the United States, Unidos US, American Benefits Council, National Association of Benefits and Insurance Professionals, National Association of Community Health Centers, Federation of American Hospitals, American Health Care Association, Association for Community Affiliated Plans, Blue Cross Blue Shield Association, and Medicaid Health Plans of America.

WHAT'S THE IMPACT?

Concurrent with the launch of the CCC, AHIP released a new Medicaid Redetermination Coverage Transitions Report, which provides a state-by-state analysis of where people who are no longer eligible for Medicaid are likely to have access to coverage. The report summarizes a comprehensive analysis conducted by NORC at the University of Chicago and supported by AHIP.

Among the key findings is that in nearly all states, the majority of people no longer eligible for Medicaid will transition to employer-provided coverage (EPC). The state with the lowest proportion of people who will enroll in EPC is Georgia (48.9%), while the state with the highest proportion of people enrolling in EPC is Delaware (57.1%).

About 3.8 million (21.2%) of people no longer eligible for Medicaid will become uninsured, the data showed.

The state with the lowest proportion of people who will become uninsured is Massachusetts (17.7%), while the state with the highest proportion is South Dakota (26.2%).

Meanwhile, the CCC's new website provides Medicaid enrollees, health care navigators, health care leaders, community leaders, and other stakeholders with information about the Medicaid redetermination process.

THE LARGER TREND

In December, President Biden signed into law a $1.7 trillion omnibus spending package that detailed a plan for Medicaid coverage determinations. 

Under the bill, states will be able to begin processing Medicaid redeterminations on April 1, and have one year to complete them. It requires state Medicaid programs to provide 12 months of continuous coverage for children and permanently allows states to offer 12 months of coverage for postpartum women, according to the American Hospital Association.

In January, CMS released information on a temporary Exceptional Circumstances Special Enrollment Period from March 31 through July 31.

Marketplaces using the federal platform will be providing additional flexibility for eligible consumers to enroll in coverage during and immediately following the end of the Medicaid continuous enrollment condition unwinding period, CMS said. This starts on April 1 as states begin redeterminations.
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com