HHS urges governors to adopt new flexibilities to keep Medicaid members covered

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Health and Human Services Secretary Xavier Becerra has sent a letter to governors urging them to adopt new flexibilities to minimize avoidable Medicaid coverage losses among children and families.  

Building on flexibilities that HHS offered to states before Medicaid redeterminations began in April, some of the new flexibilities include:

• Allowing managed care plans to assist people with Medicaid with completing their renewal forms, including completing certain parts of the renewal forms on their behalf.
• Allowing states to delay an administrative termination for one month while the state conducts additional targeted outreach. This will give people more time to be reminded to fill out and return their renewal forms.
• Allowing pharmacies and community-based organizations to facilitate reinstatement of coverage for those who were recently disenrolled for procedural reasons based on presumptive eligibility criteria.

WHY THIS MATTERS

States began Medicaid redeterminations on April 1, ahead of the announced end of the public health emergency on May 11.

The Medicaid continuous coverage requirement that kept individuals enrolled since March 2000, when the PHE began, ended. Many enrollees were unaware of the redetermination process that could end their Medicaid benefits and leave them without health insurance coverage.

Many were still eligible for Medicaid. For those no longer eligible, the Centers for Medicare and Medicaid Services opened a special enrollment period for Affordable Care Act coverage.

In his letter to the nation's governors, Becerra expressed particular concern that children who are still eligible for Medicaid or CHIP might lose coverage. He urged states to work with local governments, community-based organizations, schools, faith-based organizations and leaders, grocery stores, pharmacies and others to help people understand the Medicaid and CHIP eligibility and renewal process – citing one school district that has started sending information home with students and holding community outreach events.

THE LARGER TREND

States have varied in the number and type of flexibilities they have adopted to date. 

HHS, through CMS, has worked extensively with state Medicaid agencies to provide guidance on federal requirements, develop strategies to make Medicaid and CHIP renewals easier for people, and troubleshoot operational issues. 

This has included partnering with health plans, healthcare providers, federally-qualified health centers, home visiting programs, early childhood providers, advocates, employers, and civil rights, faith-based, health-industry and other community organizations.

ON THE RECORD

"Nobody who is eligible for Medicaid or the Children's Health Insurance Program should lose coverage simply because they changed addresses, didn't receive a form, or didn't have enough information about the renewal process," said HHS Secretary Xavier Becerra. "We encourage states to utilize all available flexibilities to ensure children and families don't lose coverage. We also urge states to join us in partnering with local governments, community organizations, and schools to reach people eligible for Medicaid and CHIP where they are."
 

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org