Tag: Enrollment

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Medicaid Enrollment & Spending Growth: FY 2021 & 2022

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The latest survey of Medicaid directors suggests that 2022 enrollment growth will slow from 10% in 2021 to 4.5% in 2022.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Key Takeaways

In March 2020, the COVID-19 pandemic generated both a public health crisis and an economic crisis, with major implications for Medicaid – a countercyclical program – and its beneficiaries. During economic downturns, more people enroll in Medicaid, increasing program spending at the same time state tax revenues may be falling. While state revenues have substantially rebounded after dropping precipitously at the onset of the pandemic, the public health crisis has continued as a new surge of COVID-19 infections, hospitalizations, and deaths, fueled by the Delta variant, began to take hold in the U.S. in late July and August 2021. To support Medicaid and provide broad state fiscal relief, the Families First Coronavirus Response Act (FFCRA), enacted in March 2020, authorized a 6.2 percentage point increase in the federal Medicaid matching rate (“FMAP”) (retroactive to January 1, 2020) if states meet certain “maintenance of eligibility” (MOE) requirements. Since then, the MOE requirements and temporary FMAP increase have been the primary drivers of Medicaid enrollment and spending trends. The fiscal relief and the MOE requirements are tied to the duration of the public health emergency (PHE).

This brief analyzes Medicaid enrollment and spending trends for state fiscal year (FY) 2021 and FY 2022 (which for most states began on July 1)1 based on data provided by state Medicaid directors as part of the 21st annual survey of Medicaid directors in states and the District of Columbia. Forty-seven states2 responded to the survey by mid-September 2021, although response rates for specific questions varied. In their survey responses, most states anticipated that the fiscal relief and MOE would end in December 2021 and that had major implications for enrollment and spending projections. The PHE was recently extended to mid-January 2022, which would affect these projections and possibly delay anticipated effects of slowing enrollment and spending currently assumed in state budgets for FY 2022. The methodology used to calculate enrollment and spending growth and additional information about Medicaid financing can be found at the end of the brief. Key survey findings include the following:

  • Enrollment growth: After increasing sharply in FY 2021 (10.3%) due to the MOE requirements and the pandemic’s economic effects, responding states expect Medicaid enrollment growth to slow to 4.5% in FY 2022, based largely on the assumption that the PHE and the related FFCRA MOE requirements will end in FY 2022 (most states assume mid-way through FY 2022).
  • Total spending growth: FY 2022 state budgets for responding states assume total Medicaid spending growth will slow to 7.3% compared to 11.4% in FY 2021. States identified enrollment growth as the primary driver of FY 2021 expenditure growth and assume slower enrollment growth will result in lower total spending growth in FY 2022.
  • State spending growth: While states reported that the state (nonfederal) share of Medicaid spending grew by 4.0% in FY 2021, they projected sharper FY 2022 growth of 14.0% based on the assumption that the PHE and related enhanced FMAP would expire in mid–FY 2022, shifting the state and federal spending shares even though total Medicaid spending growth is expected to slow.

As in 2020, the 2021 survey was fielded during a time of great uncertainty. State fiscal conditions had improved, but the rate of recovery varied across the states and employment indicators had not yet reached pre-pandemic levels. After COVID-19 infection rates dropped to encouragingly low levels in the late spring of 2021, a summer surge driven by the Delta variant was generating more uncertainty around the PHE end date, to which the MOE requirements and enhanced FMAP are tied. In their survey responses, most states projected slowing Medicaid enrollment growth and total spending growth along with increases in the share of state Medicaid spending in FY 2022 due to the assumption that MOE requirements and the enhanced FMAP would end in December 2021, half-way through the fiscal year for most states. However, the PHE was recently extended to mid-January 2022 and may be extended further if cases and deaths from the Delta variant remain high or increase heading into the winter. Extensions of the PHE would likely delay state projections/trends for spending and enrollment growth depicted in this report (for FY 2022). How states respond to the eventual end of the PHE and the unwinding of their MOE will have significant implications for enrollment and spending.

Context

Following declines from 2017 through 2019, total Medicaid and CHIP enrollment nationwide began to grow following the onset of the COVID-19 pandemic. Between February 2020 and April 2021, enrollment grew to 82.3 million, an increase of 11.1 million or 15.5%. In 2020, Medicaid (together with CHIP) provided coverage to nearly one in five Americans. This enrollment growth reflects both changes in the economy, as people enrolled following income and job losses, as well as the FFCRA MOE provisions that require states to ensure continuous coverage for current Medicaid enrollees to access a temporary increase in the FMAP rate. Total Medicaid spending was over $662 billion in FY 2020 with 67.4% paid by the federal government and 32.6% financed by states. Medicaid accounts for one in six dollars spent in the health care system and more than half of spending on long-term services and supports.3

States experienced a dramatic and rapid reversal of their fiscal conditions when the pandemic hit in March 2020. Before the pandemic, unemployment was low, states expected revenues to grow for the 10th consecutive year, and state general fund spending was on track to grow by 5.8%. In this context, governors developed FY 2021 budget proposals that reflected continued revenue and spending growth. The pandemic began during the second half of FY 2020 and quickly reversed state fiscal conditions. Early estimates projected state budget shortfalls of up to $555 billion for fiscal years 2020 through 2022, and states experienced their first general fund revenue decline in FY 2020 since the Great Recession, though some declines in revenue can be attributed to states delaying their 2020 income tax collections from April to July (the start of FY 2021 for most states). Faced with continued uncertainty regarding the course of the pandemic, ongoing revenue collections, and additional federal fiscal relief, states adopted conservative FY 2021 budgets. Unlike the federal government, states must meet balanced budget requirements. To address budget shortfalls heading into FY 2021, states used strategies such as layoffs or furloughs for state workers, hiring freezes or salary reductions, across the board spending cuts, or one-time use of rainy day funds.

State economic conditions have since improved mitigating the need for widespread spending cuts last year. National economic indicators have moderated in recent months. For example, September 2021 saw a national unemployment rate of 4.8% across all states including DC, below the peak of 14.8% in April 2020 but still above the February 2020 rate of 3.5% right before the pandemic. State revenue collections have rebounded
due, in part, to federal aid provided to states, improved state sales tax collections on online purchases, and smaller personal income tax revenue declines due to the disproportionate impact of the pandemic on low-income workers. While state general funds are estimated to have grown by 3% in FY 2021, general fund spending in FY 2021 remained 2% below spending projections made before the pandemic. In FY 2022, however, general fund spending is expected to grow by 5%. In contrast to budgets adopted for FY 2021, proposed FY 2022 state budgets did not include general fund spending decreases, and most states enacted FY 2022 budgets with increased state spending and revenue.

Viewed nationally, state fiscal conditions have improved, but pandemic-related economic impacts vary by state. The severity of the pandemic-induced economic downturn and speed of recovery varies by state depending on state characteristics such as tax structure, industry reliance, social distancing policies and behaviors, and virus transmission. Economic indicators are improving across states, with indicators for some states returning to pre-pandemic levels while others remain distressed. For example, in September 2021, Nebraska saw an unemployment rate of 2.0%, which is below their pre-pandemic rate of 3.0% in February 2020, while Nevada’s unemployment rate was 7.5%, well above their pre-pandemic unemployment rate of 3.7%. While state revenues overall appear to have surpassed pre-pandemic levels, there is variation across states. Also, this data pre-dates the recent Delta variant fueled COVID-19 surge and is volatile due to most states delaying their income tax filing deadlines for 2020 and 2021.

While the FFCRA FMAP increase currently continues to support Medicaid programs and provide broad fiscal relief to states, states are preparing for the FMAP increase to end in FY 2022. In the past, federal fiscal relief provided through Medicaid FMAP increases during significant economic downturns has helped to both support Medicaid and provide efficient, effective, and timely fiscal relief to states. FFCRA uses this model as well by providing a temporary 6.2 percentage point increase in the Medicaid FMAP from January 1, 2020 through the end of the quarter in which the PHE ends. The current PHE declaration expires in mid-January 2022, meaning the enhanced FMAP will remain in place until the end of March 2022 unless the PHE is extended further. This FMAP increase does not apply to the Affordable Care Act (ACA) expansion group, for which the federal government already pays 90% of costs. To be eligible for the funds, states must meet certain MOE requirements that include not implementing more restrictive Medicaid eligibility standards or higher premiums and providing continuous eligibility for enrollees through the end of the PHE. Though the recent rise in COVID-19 cases and deaths due to the Delta variant cast uncertainty on the duration of the PHE, states are beginning to prepare for the end of MOE requirements, and new guidance from CMS gives states 12 months to address Medicaid eligibility renewals and redeterminations following the end of the PHE.

Key Findings

Trends in Enrollment Growth FY 2021 and FY 2022

Medicaid enrollment growth peaked in FY 2021 and is expected to slow in FY 2022 (Figure 1). Medicaid enrollment growth peaked in FY 2015 due to ACA implementation and tapered thereafter. Enrollment actually declined in FY 2018 and FY 2019 and was relatively flat in FY 2020. Enrollment rose sharply, however, in FY 2021 (10.3%), and is projected to continue to grow, though more slowly, in FY 2022 (4.5%). Many states noted uncertainty in their projections due to the unknown duration of the PHE and related MOE requirements. Following the end of the MOE requirements, redeterminations will resume, and eligibility will end for beneficiaries who are determined to no longer meet eligibility standards. For budget projections, a majority of states were assuming the MOE would end as of December 31, 2021. This assumption was contributing to slowing enrollment growth in FY 2022; however, states also identified challenges to resuming normal eligibility operations such as the need for system changes, staffing shortages, and the volume of new applications and redeterminations.

States largely attributed enrollment increases to the FFCRA’s MOE requirements. All responding states reported that the MOE requirements were a significant upward pressure on FY 2021 enrollment. Over two-thirds of responding states reported that the MOE was likely to be a significant upward driver of FY 2022 enrollment, though some assumed that this upward pressure would end mid-year. In the absence of the MOE, individuals may lose Medicaid coverage because they have a change in circumstance (such as an increase in income), because they fail to complete renewal processes or paperwork even when they remain eligible, or because they age out of a time- or age-limited eligibility category (e.g., pregnant women or former foster care youth). In FY 2021, only about a quarter of states noted that the economy was a significant upward pressure on enrollment. Conversely, signs of economic improvement at the time of the survey likely contributed to some states citing economic conditions as a downward pressure on enrollment in FY 2022. Among Medicaid expansion states that responded to the survey, expansion adults were the most frequently mentioned eligibility group with notably higher rates of enrollment growth relative to other groups.  States also reported that groups more sensitive to changes in economic conditions (e.g., children, parents, and other expansion adults) grew faster than the elderly and people with disabilities.

Trends in Spending Growth FY 2021 and FY 2022

FY 2022 state budgets for responding states assume total Medicaid spending growth will slow to 7.3% compared to a peak of 11.4% in FY 2021 (Figure 2). High rates of enrollment growth, tied first to the Great Recession and later to ACA implementation, were the primary drivers of total Medicaid spending growth over the last decade. Following ACA implementation but prior to the pandemic, declining or slowing enrollment growth resulted in more moderate spending growth. In prior surveys, states noted that spending growth in FY 2020 (prior to the major effects of the pandemic) was tied to increasing costs for prescription drugs (particularly for specialty drugs), rate increases (most often for managed care organizations, hospitals, and nursing facilities), overall medical inflation, pressures from an aging state population, and a higher acuity case-mix.

FY 2021 spending growth increased sharply, primarily due to enrollment growth. Some states noted upward pressures from increased COVID-19 related expenditures, but half of states reported pandemic-related utilization decreases for non-COVID care as a downward pressure on overall spending. A majority of states reported acute care utilization on a per member basis decreased in FY 2021, but most of these states expect a full rebound in acute care services utilization in FY 2022 (most states were responding to the survey before a new surge in cases from the Delta variant were emerging). Most states indicated nursing facility utilization decreased in FY 2021; however, a majority of states noted the decreased utilization was partially or fully offset by utilization in home and community-based services (HCBS). Among states seeing decreases in nursing facility utilization, only a small number expect nursing facility utilization to fully rebound in FY 2022. Changes in payment rates and utilization patterns for acute and long-term care services may have contributed to states reporting that per enrollee spending for the elderly and people with disabilities was growing faster relative to other groups in FY 2021.

For FY 2022, a majority of states expect enrollment growth trends to be a primary factor driving total spending growth.  While a majority of states cited enrollment as an upward pressure, over a third of states expect enrollment to become a downward pressure in FY 2022, assuming that the MOE requirements end midway through FY 2022 and states would resume redeterminations resulting in slower enrollment growth. Beyond enrollment, states reported additional upward pressure coming from provider rate or cost changes and increased utilization driven by a return to pre-pandemic utilization levels or by pent up demand resulting from pandemic-related delays in care.

Assumptions about the duration of the PHE and the expiration of the enhanced FMAP affected state Medicaid spending growth assumptions (Figure 2). The state share of Medicaid spending typically grows at a similar rate as total Medicaid spending growth unless there is a change in the FMAP rate. During the Great Recession, state spending for Medicaid declined in FY 2009 and FY 2010 due to fiscal relief from a temporary FMAP increase provided in the American Recovery and Reinvestment Act (ARRA). State spending increased sharply when that fiscal relief ended.

This pattern has repeated during the pandemic-induced economic downturn, with state Medicaid spending declining in FY 2020, increasing but at a slower rate than total spending in FY 2021, and then projected to increase sharply to surpass total Medicaid spending in FY 2022 due to assumptions about the expiration of the fiscal relief. More than three-quarters of responding states assumed the enhanced FMAP rate would end December 31, 2021, half-way through the state fiscal year, with only two states assuming a later date. The spike in state spending growth reflects these assumptions. However, the recent PHE extension to mid-January 2022 extends the enhanced FMAP through at least March 2022, which will mitigate the state spending increase observed here. Of course, a further extension of the PHE due to the Delta variant or other factors could mean that the enhanced FMAP would be in place through June 2022 (the end of the state fiscal year for most states), meaning the spike in state spending would not occur until the following fiscal year.

Nearly all responding states report using the federal fiscal relief to support costs related to increased Medicaid enrollment. About two-thirds of responding states also report using the fiscal relief to help address Medicaid or general budget shortfalls and mitigate provider rate and/or benefit cuts. Fewer states anticipate Medicaid budget shortfalls in FY 2022 (prior to the Delta variant surge) compared to last year’s survey, reflecting improving state revenues that allow states to fund their share of Medicaid spending increases. However, many states noted the importance of federal fiscal relief to avoiding a shortfall and uncertainty of a shortfall due to the unknown duration of the enhanced FMAP.

Conclusion and Looking Ahead

State economic conditions have improved, though the recovery varies across states and employment indicators have not yet reached pre-pandemic levels. Almost all states have adopted budgets for state fiscal year 2022 (which started July 1 in most states), and revenue and spending projections incorporated improvements in revenue reflecting increased economic activity due to COVID-19 vaccination efforts and eased restrictions, assumptions about the duration of the PHE, and federal stimulus funds that were part of the American Rescue Plan. A summer surge in COVID-19 cases, hospitalizations, and deaths driven by the Delta variant, however, has generated greater uncertainty regarding future state fiscal conditions.

The end date of the PHE remains uncertain and will have significant implications for Medicaid enrollment and spending. The recent COVID-19 surge casts further uncertainty around the duration of the PHE and the MOE requirements and enhanced FMAP that are tied to the PHE. The MOE requirements and enhanced FMAP have already been extended further than most states anticipated in their budget projections and may be extended even further if the current COVID-19 surge continues or worsens. If the PHE is extended beyond January, Medicaid enrollment growth will likely continue in FY 2022, but the expected increase in state Medicaid spending will be delayed while the enhanced federal fiscal relief remains in place. Regardless of when the PHE ends, most states will start to prepare for the eventual unwinding of their MOE policies and procedures, as resuming Medicaid eligibility renewals will be a large administrative task for states. Guidance from CMS gives states 12 months to complete renewals and redeterminations following the end of the PHE. Additional guidance and oversight from the federal government could help mitigate differences in how states approach the end of the MOE. With the unwinding, states are likely to face pressures to contain growth in state spending tied to enrollment, particularly after the enhanced FMAP ends, even as they work to overcome challenges with systems and staffing to ensure that eligible individuals remain covered by Medicaid or transition to other sources of coverage.

 
 

Clipped from: https://www.kff.org/medicaid/issue-brief/medicaid-enrollment-spending-growth-fy-2021-2022/

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DMAS prepares for post-public health emergency Medicaid disenrollment

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Virginia is gearing up for the disenrollment effort.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

DMAS prepares for post-public health emergency Medicaid disenrollment – State of Reform | State of Reform

  

The Department of Medical Assistance Services (DMAS) is currently preparing for the impending end of the federal public health emergency (PHE) declaration, which will instigate a lengthy eligibility redetermination process for one in five Virginians who currently benefit from Medicaid. 

 
 

DMAS Director Karen Kimsey provided an update on the organization’s preparation for potential disenrollment, or “unwinding,” and its impact on the state budget to the Joint Subcommittee for Health and Human Resources Oversight earlier this month. 

Medicaid enrollment has increased significantly in the state, with 373,634 new members enrolling in Medicaid since the beginning of the State of Emergency on Mar. 12, 2020. Over 116,000 of these were children. DMAS also implemented several policy changes this year, such as extending postpartum coverage and adding dental services, that are associated with added costs to the state budget. 

Kimsey was unable to provide exact spending numbers for the next fiscal year as DMAS is still preparing to submit its 2022 Medicaid forecast on Nov. 1. However, she said increased federal funding has saved the state an average of $133 million per quarter. DMAS will also reinvest additional state general fund savings into home and community-based services (HCBS), which stem from federal American Rescue Plan (ARP) funding. 

However, Kimsey said the agency must pay attention to potential changes in the state’s Medicaid population.

 
 

“While the longer PHE will continue to bring [general fund] savings from enhanced FMAP, if that happens, there is a cost for us, as the Commonwealth, in terms of keeping our populations on Medicaid, as well as what time we are going to need once it ends, to actually redetermine all those individuals’ [eligibility].” 

 
 

Virginians under Medicaid are currently protected from being disenrolled due to the Families First Coronavirus Response Act. However, once the PHE ends, DMAS will need to redetermine each member’s eligibility, a lengthy process that Kimsey said can take anywhere from six to 12 months. This is in part because eligibility may be determined at a local-level, case-by-case basis. 

The Centers for Medicare and Medicaid Services (CMS) have released guidance for states as they begin the redetermination process, but did not specify exactly when the PHE will end. The most recent PHE renewal will expire on Oct. 18, and the Department of Health and Human Services (HHS) expects to renew it one more time through the end of 2021, according to Kimsey. However, that means the PHE could expire as soon as Jan. 2022. 

The disenrollment freeze prevented an exact estimate of people who would lose Medicaid eligibility, although Kimsey said over 337,000 cases (equating to over 644,000 members) in the state may need to be redetermined. This included individuals who turn 65 and may need to transfer to Medicare, pregnant people who reached the end of the postpartum coverage period, and individuals with changes in circumstances, such as increased income.

Kimsey said DMAS is currently working with several partners across the state to provide navigation resources to disenrolled members. CMS is also employing marketing campaigns to encourage people to sign up for insurance through the market exchange, as well as extending open enrollment until Jan. 15, 2022.

 
 

“That’s going to be the most important part, is the messaging that we share with individuals to help encourage them along [in applying].”

 
 

One of DMAS’s partners is the Virginia Poverty and Law Center (VPLC). In a previous conversation with State of Reform, Deepak Madala, Esq., VPLC director of the Center for Health Communities and ENROLL Virginia!, mentioned the importance of making resources more accessible for underserved communities, such as providing limited-English proficiency (LEP) individuals with resources in their native languages. 

Aside from the redetermination process, Kimsey shared other updates with subcommittee members. During the August special session, the General Assembly approved a 12.5% increase in reimbursement rates for Medicaid providers. The funding has been available since July 31, although it has yet to be transferred to providers. Kimsey said DMAS would “ideally” have funds transferred by the end of this month.

Kimsey also briefly spoke on DMAS’s Cardinal Care program, which will consolidate the agency’s managed care organizations with its fee-for-service programs in a single contract by July 1, 2022. DMAS plans to share a draft of the contract with relevant stakeholders in Spring 2022. 

A full recording of DMAS’s legislative update can be found here.

 
 

https://stateofreform.com/news/virginia/2021/10/dmas-prepares-for-post-public-health-emergency-medicaid-disenrollment/

 
 

 
 

  

 

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Brooks-LaSure: ACA marketplace key to Medicaid redeterminations after COVID-19 PHE ends

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The CMS chief is pointing to the exchanges to deal with PHE-driven eligibility terminations.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

CMS Administrator Chiquita Brooks-LaSure is seeking to streamline enrollment between Medicaid and Affordable Care Act exchanges once states start to redetermine Medicaid eligibility after the public health emergency expires. (Getty/kroach)(Credit: Getty/kroach)

The Biden administration plans to lean heavily on the Affordable Care Act’s insurance exchanges to sign up people who may quickly drop off Medicaid’s rolls once the public health emergency ends, according to the head of Medicare and Medicaid.

Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure said that the agency realizes states have a pending dilemma with how to redetermine Medicaid eligibility after the end of the COVID-19 public health emergency ends, which could be some time next year. The emergency prevented states from dropping Medicaid beneficiaries from the program.

Brooks-LaSure spoke of the issue on Friday during the Medicaid Health Plans of America conference in Washington. The group represents the Medicaid managed care industry.

“We do understand the pressures that states are under,” she said during a virtual speech.

The agency also has concerns about how to maintain coverage levels for individuals who may lose Medicaid eligibility because they earn too much. CMS gave states a year after the emergency ends to restore normal income eligibility requirements.

Brooks-LaSure said that ACA marketplace coverage is going to play a key part in keeping people covered after the emergency ends.

“We are very focused on integrating as closely as we can Medicaid and marketplace coverage,” she said. “We actually have a unique opportunity to … streamline enrollment because of the American Rescue Plan.”

The administrator was referring to enhanced income-based subsidies passed under the law earlier this year and expire after the 2022 coverage year. Democrats in Congress are working to extend the subsidies past that date as part of a $3.5 trillion infrastructure package.

“We have people right about the Medicaid level who have much higher subsidies than they do normally,” she said.

CMS has also made moves to ensures signups on the marketplace are easier, including extending by 30 days the 2022 open enrollment period that starts in November.

There are also special enrollment periods for people to sign up if they lose coverage, Brooks-LaSure added.

“That is one way we can continue to ensure that people move into care if they are losing eligibility because of income,” she said.

The end of the public health emergency could affect coverage for millions of people, a recent study said.

The study conducted by the Urban Institute found that 15 million people could be dropped off the Medicaid rolls after the emergency ends. States will need to inform enrollees of other coverage options such as the ACA marketplace, researchers said.

Aligning care for duals

Brooks-LaSure also spoke about the need to improve integrated care between Medicare and Medicaid for dual-eligible beneficiaries.

“They are currently an underserved population,” she said.

CMS did create dual-eligible special needs plans which are Medicare Advantage plans available to duals.  

However, about 3 million dual-eligible beneficiaries are enrolled in such plans out of roughly 10 million dual eligibles.

“As we all know Medicare and Medicaid have different payment incentives and so it is so important to make sure that care is integrated,” Brooks-LaSure said. “One of the things we are also looking at is these times where people are enrolled in different managed care programs … and can we align there.”

 
 

Clipped from: https://www.fiercehealthcare.com/payer/brooks-lasure-aca-marketplace-key-to-medicaid-redeterminations-after-covid-19-phe-ends

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15 million people may lose Medicaid coverage when public health emergency ends

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Most who lose their Medicaid coverage are expected to have employer-based or subsidized exchange coverage when the PHE ends.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

By Maria Marabito

Source/Disclosures

Source:

What will happen to unprecedented high Medicaid enrollment after the public health emergency? https://www.rwjf.org/en/library/research/2021/09/what-will-happen-to-unprecedented-high-medicaid-enrollment-after-the-public-health-emergency.html. Published Sept. 15, 2021. Accessed Sept. 16, 2021.

Disclosures: Buettgens reports no relevant financial disclosures.

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A new report showed that about 15 million Americans who enrolled in Medicaid during the public health emergency could lose coverage when the emergency declaration ends.

Those at risk for losing coverage include almost 9 million adults and 6 million children, according to the analysis published by the Urban Institute with support from the Robert Wood Johnson Foundation.

aid coverage saves lives and increases families’ financial stability. Becoming uninsured would adversely affect both,” Matthew Buettgens, PhD, a senior fellow in the Health Policy Center at the Urban Institute, told Healio Primary Care. “Many of those losing Medicaid would be eligible for other types of health coverage, and states can substantially reduce the number becoming uninsured by providing effective outreach and assistance.”

Buettgens and coauthor Andrew Green, MSDSPP, a research analyst in the Health Policy Center at the Urban Institute, analyzed state enrollment patterns from February 2020 to January 2021 using Medicaid enrollment data from CMS and individual state Medicaid websites for all available months in 2020 and 2021. They projected possible disenrollment scenarios for 2022.

By the end of the second quarter of 2020, about 62.5 million nonelderly people were enrolled in Medicaid. Following this period, enrollment increased by about 1% each month. Buettgens and Green said they expect this trend to continue while the emergency declaration is still in place. By the second quarter of 2021, they approximated that 72 million nonelderly people were enrolled.

Moreover, Buettgens and Green estimated that 17 million more nonelderly people will be enrolled in Medicaid at the end of 2021 compared with enrollment prior to the pandemic. Overall, an estimated 76.3 million individuals aged younger than 65 years would be enrolled, according to Buettgens and Green.

In a scenario where the emergency declaration is lifted at the end of 2021, the researchers predicted that 15 million people would lose coverage in 2022, while one-third of adults would potentially qualify for subsidized private health coverage in the Healthcare Marketplace. The remaining individuals without coverage would likely have access to employer coverage through their family or be eligible for other sources of subsidized coverage, the authors wrote. If the American Rescue Plan Act is made permanent, one-third of adults losing coverage would be eligible for Marketplace premium tax credits.

Among the children losing coverage, only 57% would be eligible for the Children’s Health Insurance Program, and 9% would be eligible for Marketplace coverage with tax credits, according to the authors. These alternatives to Medicaid will likely cost families much more, Buettgens and Green wrote. They projected that 7 million people will become disenrolled in the first half of 2022.

However, the tax credits would make private health coverage more affordable, according to Buettgens.

 
 

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“If a patient has lost Medicaid, a physician could suggest that they check with HealthCare.gov or their state Marketplace to see if they qualify,” he said.

Clipped from: https://www.healio.com/news/primary-care/20210921/15-million-people-may-lose-medicaid-coverage-when-public-health-emergency-ends

 
 


 

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Montana’s plan to end continuous Medicaid coverage sparks objections

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MT lawmakers want to increase the frequency of eligibility determinations to reduce spending on ineligible members, but some advocates say the disruption to care is not worth it.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

HELENA — Some Montana Medicaid recipients are pushing back against plans to end 12-month continuous coverage for certain people enrolled in public health insurance programs as the state’s public comment period on the new policy draws to a close. If successful, the change would likely alter two Medicaid programs in Montana in significant ways, both for enrollees who rely on the state for health care coverage and for officials tasked with operating the new system.

The state will stop accepting public comment on its proposals on Aug. 31.

While the state Department of Public Health and Human Services estimates that ending continuous eligibility, or a year of uninterrupted health care coverage, will save the federal and state governments roughly $22 million a year in the cost of benefits, critics say the change could result in temporary lapses in coverage for more than 20,000 people in a given year. 

Inherent to opponents’ concerns is the prospect of Montanans losing coverage because of paperwork, communication and bureaucratic errors rather than true income ineligibility, an outcome DPHHS has said it would make every effort to avoid. 

“I’m still unclear as to what the outcome is that the department hopes to seek. But I am pretty sure that, whether intended or not, the outcome will be a reduction in the rolls.”

Rep. Mary Caferro, D-Helena

The department contends that checking eligibility on a more frequent basis will help ensure that people who don’t qualify for the public program won’t remain on the rolls, saving the state money in the process.

But vagueness about what might replace the state’s current system has sparked anxiety among some residents insured by the impacted programs, including single adults with incomes below 138% of the federal poverty level and people diagnosed with a serious disabling mental illness (SDMI). 

“I depend on Medicaid for my mental health problems, and when I have my medicine I feel normal. Please don’t make me worry about going without my medicine,” said one man in a written comment submitted to the department through the nonprofit Montana Women Vote. “Do not end continuous eligibility.”

Montana Free Press is not publishing the names of quoted commenters, who did not respond to interview requests, in order to protect personal medical information. Montana Women Vote estimated it has helped submit roughly 175 comments from individuals in the past month.

Another woman wrote to the department out of concern for her goddaughter, saying it would be “unfair and cruel to end continuous eligibility,” and that the change would make it “difficult or impossible” for her goddaughter to maintain health care coverage.

One recipient told state health officials he depended on Medicaid for “life saving” medicine for diabetes, and urged them not to alter the program’s verification process.

“Please don’t do this to the people that depend on this,” he wrote.

‘UNDER THE DIRECTION’ OF THE STATE LEGISLATURE

Montana and New York are currently the only states that permit continuous eligibility through an agreement with the federal government agency that administers Medicaid and Medicare. Ending continuous eligibility would happen through a waiver submitted to those federal officials, who may accept or reject the proposal. 

The draft waiver changes developed by DPHHS contain no details about what would replace Montana’s current process of vetting eligibility and income once a year. Department staff said deliberations about program logistics will likely continue between federal and state officials after the waivers are submitted.

“We are implementing this waiver change under the direction of the Montana state Legislature. The funding to pay for continuous eligibility was removed from our budget and there was clear language in directing us to pursue this policy.”

Marie Matthews, DPHHS

The department’s move comes in the wake of a legislative session in which lawmakers failed to pass a complex bill, Senate Bill 100, that would have ended continuous eligibility and made several other changes to how Montana verifies Medicaid eligibility.

Late in the session, lawmakers then passed a budget amendment authorizing DPHHS to end continuous eligibility for adults who are covered through the 2015 Medicaid expansion program. That group includes single adults whose income is up to 138% of the federal poverty level. Nearly 10% of Montana’s total population, or 101,484 enrollees, were covered by Medicaid expansion as of this July.

“We are implementing this waiver change under the direction of the Montana state Legislature,” DPHHS Medicaid and Health Services branch manager Marie Matthews said in an August hearing before lawmakers. “The funding to pay for continuous eligibility was removed from our budget and there was clear language in directing us to pursue this policy.”

Though not instructed to do so by the state Legislature, DPHHS has said it will also submit a waiver amendment to the federal government to end continuous eligibility for roughly 20,000 Montanans covered by the WASP (Waiver for Additional Services and Populations) program, which insures low-income families and caretakers as well as people 18 and older who are diagnosed with a serious disabling mental illness (SDMI). The department has said its reason for doing so is to avoid “significant additional administrative burden” if the state continues 12-month continuous eligibility in one program and not the other.

During the August meeting, department officials stressed that a person would be removed from the program only after verification that their permanent monthly income level has exceeded the eligible amount.

“If somebody makes enough income that they’re no longer eligible for Medicaid coverage, then the next tier is the subsidized [Affordable Care Act] plans on the exchange,” said DPHHS Director Adam Meier, who added that he would expect some residents’ health outcomes to eventually improve after leaving Medicaid, based on a presumption that they will have a larger income.  

“I would think that as people improve their economic situations, as they’re making more income, that would then be their impetus for no longer qualifying [for Medicaid], then we may see a corresponding increase or improvement in health outcomes,” Meier said.

THE ‘HUMAN ELEMENT’ TO POLICY CHANGE

None of the members of the public who testified before lawmakers in August voiced support for the proposed DPHHS waivers. 

Asked how many public comments the department had received so far, and whether those comments supported or opposed the proposals, a DPHHS spokesperson told MTFP that information will be available after public comment closes on Aug. 31 and the department has submitted its proposals to the federal government. 

Democratic lawmakers on the Children, Families, Health, and Human Services Interim Committee in August repeatedly asked members of the department to explain what they consider the benefits of discontinuing continuous eligibility, and how many people would likely be impacted by the change. 

“There’s lots of research that basically shows that by providing people more stable coverage, they end up being healthier. They are able to get primary and preventive care so that they don’t have a diabetic coma, so that if they have asthma, they don’t end up in the emergency room.”

Dr. Leighton Ku, Director of the Center for Health Policy Research at George Washington University

“I’m still unclear as to what the outcome is that the department hopes to seek,” said Rep. Mary Caferro, D-Helena. “But I am pretty sure that, whether intended or not, the outcome will be a reduction in the rolls.”

The department, citing a 2013 study conducted by researchers from George Washington University, estimated that ending continuous eligibility would reduce months of coverage by 2.6%. Caferro said that calculation seems to use “sterile language” to avoid accounting for the impact on real Montanans.

“You know, when you say 2.6% of whatever, we’re talking about people,” she said. “WASP, for example, covers people who are seriously mentally ill and also the families who live in extreme poverty … we are talking about people’s health care and people’s lives.”

Pinpointing the number of people affected by the waiver change is difficult, said Dr. Leighton Ku of George Washington University, one of the researchers whose work DPHHS cited in its estimate of reduced coverage. 

In a written comment submitted to the department and in a later phone interview, Ku said a reduction of 2.6% covered months would likely be distributed across enrollees who would temporarily lose coverage for a short amount of time within a year. If enrollees had their coverage discontinued for roughly two months before they could re-enter the program, Ku said, the number of affected residents could reach as high as 15.6%, or roughly 21,500 people.

Ku said that “churn,” the process of people exiting public programs only to re-apply a short time later, can also create administrative strain on public health departments, on top of the increased vetting and communication demands on state employees. In its proposed waiver changes, DPHHS does not estimate the anticipated costs of running the program with more frequent eligibility checks.

If people fall through the cracks because of miscommunication with DPHHS about their income and eligibility, Ku said, their health care may also be more expensive when they come back to a public health insurance program. More importantly, he said, interrupted health care could have serious repercussions for some individuals.

“If you have diabetes, for example, that means that actually you want your insulin and your medications all year round,” Ku said. “You don’t want to say, OK, insulin for 10 months, two months I’ll go without. That’s how you end up having problems. Like you go into diabetic coma.”

Nationally, health care researchers have encouraged states to enact continuous eligibility policies for particularly vulnerable people with public insurance, such as children, because of improved long-term health outcomes. Ku said he and others are suggesting that states apply that perspective to their Medicaid policies for adults as well. 

“There’s lots of research that basically shows that by providing people more stable coverage, they end up being healthier. They are able to get primary and preventive care so that they don’t have a diabetic coma, so that if they have asthma, they don’t end up in the emergency room,” Ku said. “If there is someone who has, you know, a mental health problem, that they don’t go off their medications, they can still get counseling, so they don’t have a psychotic attack.”

After the close of public comment next Tuesday, DPHHS has until Sept. 3 to apply changes to the proposed waivers and submit them to the federal government. Before any waivers are approved, federal officials will open another 30-day public comment period and could enter negotiations with state officials on the details of proposed plans.

One other logistical reality hangs over Montana and other states looking to change their enrollment and eligibility processes for Medicaid. Given the federally declared public health emergency in place because of the COVID-19 pandemic, states must keep continuous eligibility in place or risk losing an enhanced federal match rate for Medicaid. 

In its presentations on the topic, DPHHS has said it will continue to follow the federal pandemic guideline so as not to sacrifice that boosted rate. The department has said the federal emergency declaration is expected to continue until Dec. 31, and could possibly be extended further, likely pushing the implementation of any changes to Montana’s Medicaid programs into 2022.

by Eric Dietrich 08.23.202108.23.2021

 
 

Clipped from: https://montanafreepress.org/2021/08/25/montana-plan-end-continuous-medicaid-coverage/

 
 

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Iowa in ‘uncharted territory’ as Medicaid numbers swell

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Iowa’s enrollment in traditional Medicaid has surged 16% while enrollment by the expansion population has surged 30%.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

COVID pandemic fuels surge in sign-ups for health insurance program

 
 

 
 

A stethoscope sits on an examination table in an exam room. (Bloomberg News)

DES MOINES — Enrollment in Medicaid and Iowa’s related Health and Wellness insurance programs saw double-digit surges in Iowa due to the COVID-19 pandemic, according to data compiled by a state forecasting group.

Since the pandemic hit Iowa in March 2020, Iowa’s regular Medicaid program added 64,134 individuals through last month while an additional 51,669 individuals enrolled in the Health and Wellness program that offers slightly fewer benefits for recipients between the ages of 19 and 64 who are not pregnant and do not earn more than 133 percent of the federal poverty level.

That represented a 15.56 percent increase when comparing July’s 487,193 Medicaid enrollees to the 423,059 enrolled when the pandemic began, said Jess Benson, a senior Legislative Services Agency fiscal analyst who provides data for the state’s Medicaid Forecasting Group.

The increase in the Health and Wellness program was even steeper, jumping 30 percent, from 176,903 participants in March 2020 to 228,572 last month.

Last month’s Medicaid total included 280,905 children, 90,436 adults, 83,231 disabled Iowans and 32,621 elderly residents.

“We’ve never experienced anything like this before so this is kind of uncharted territory for all of us,” Benson said.

The influx of more than 115,000 new enrollees gradually built as Iowans lost their jobs – and their employer-based health insurance – as the pandemic took hold. State officials project Medicaid and the Health and Wellness program will continue to add 3,000 to 7,000 individuals per month through December. At that point, the eligibility parameters may change, lifting a current prohibition on “dis-enrolling” individuals while a federal public health emergency is in effect.

The suspension of program dis-enrollments is a condition for Iowa receiving a 6.2 percent matching fund rate in federal assistance as part of the COVID-19 relief package. That adjustment of nearly $135 million in fiscal 2020 and $275.4 million last fiscal year enabled Iowa’s Medicaid program to amass “huge carry-forward” balances, Benson noted. Those balances are projected at $244 million for fiscal 2021 and $228 million in the current fiscal year that began July 1.

The matching federal funds helped provide some relief to states struggling to afford the increasing pace of sign-ups for Medicaid, a program for low-income and disabled people.

Once the state is allowed to drop individuals who no longer need or qualify for Medicaid, Benson said he expects enrollment will gradually decline by 100,000 or more. He said reviews will take place to remove people who “normally would have fallen off,” but he was not certain the numbers would settle back to the previous levels around 425,000 Medicaid participants.

“It seems like whenever we go through one of these massive expansions, when we pull back we never get back to that level that we were at before,” he said.

Earlier this year, the federal Centers for Medicare and Medicaid Services released data indicating that nearly 9.9 million people enrolled in Medicaid and the Children’s Health Insurance Program between February 2020 and January 2021 because of the COVID-19 pandemic – a 13.9 percent increase nationally. Iowa’s increase at that time was in the 12 percent range.

Comments: (515) 243-7220; rod.boshart@thegazette.com

 
 

Clipped from: https://www.thegazette.com/health-care-medicine/iowa-in-uncharted-territory-as-medicaid-numbers-swell/

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MO- Medicaid expansion applications ‘will sit there’ until October, official tells Missouri state workers

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Newly eligible expansion members won’t get their applications processed for another month while the state works on system changes.

 
 

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 

JEFFERSON CITY — A Department of Social Services official told employees recently that forms from Missourians seeking health care coverage under Medicaid expansion “will sit there” for nearly two months while the state makes system updates.

“The applications will sit there until we have the eligibility piece in, which will be Oct. 1,” Kim Evans, director of the Family Support Division, told workers in a video obtained by the Post-Dispatch through an open records request.

Despite the planned delay, the Aug. 11 video also indicates the state currently has the ability to enroll new applicants, a departure from a news release sent out the same day by Gov. Mike Parson’s office, which suggested it didn’t.

“Staff will go ahead and do the verifications that are needed on the applications,” Evans said. “But what we will do is, we will not — we will not run a determination. We will not finalize these applications. We will let the system do that on October the first.”

Parson’s news release didn’t mention DSS’ apparent ability to “run a determination” or “finalize” applications prior to Oct. 1.

The recorded message, as well as Parson’s newsrelease, followed a Cole County judge’s Aug. 10 order directing the state not to deny Medicaid applications from individuals eligible under expansion, which 53% of voters supported in an August 2020 referendum.

 
 

Clipped from: https://www.stltoday.com/news/local/govt-and-politics/medicaid-expansion-applications-will-sit-there-until-october-official-tells-missouri-state-workers/article_458dad33-b8a7-53c8-8e72-65d2126d7826.html

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CMS extends deadlines for Medicaid redeterminations after COVID-19 public health emergency ends

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States now have 12 months (instead of 6) to conduct re-determination exercises once the PHE is declared over.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Dive Brief:

  • CMS is extending the timeframe states have to complete pending verifications, redeterminations based on changes in circumstances and renewals for Medicaid, the Children’s Health Insurance Program and Basic Health Program beneficiaries after the federal public health emergency for COVID-19 ends, according to a Friday letter from the agency.
  • Due to significantly increased workloads, state health officials will now have 12 months instead of six after the PHE ends to complete those tasks. It doesn’t change the four-month timeframe after the PHE ends that they have to resume the timely processing of all applications, however.
  • The letter also does not confirm when the federal PHE will end, as it has been extended multiple times. CMS will provide additional detailed guidance on the updated policies in the coming months, it said.

Dive Insight:

Enrollment in Medicaid and CHIP has grown to a record high, with more than 81 million beneficiaries. That’s largely due to the Medicaid continuous enrollment requirement tied to pandemic relief legislation that ceased typical churn, according to the letter.

A disruption in operations caused by the pandemic and the continuous enrollment requirement mean states will be faced with high volumes of eligibility and enrollment actions they’ll need to complete after the PHE and flexibilities that came with it end to ensure eligible beneficiaries don’t lose coverage.

States expressed concern that the original six-month timeframe CMS gave in December 2020 to complete growing backlogs would result in a “renewal bulge,” causing greater administrative burden that could be much more manageable within a larger time frame, according to the letter.

Beneficiaries also risk losing coverage if states held to that timeframe are unable to conduct outreach and put in place strategies to make accurate redeterminations and renewals.

The previous guidance also allowed states to avoid completing another redetermination before terminating coverage after the PHE ends if certain conditions are met, including that eligibility actions processed during the PHE were finished within six months of the beneficiary’s termination after the PHE.

But allowing states to avoid “repeat redeterminations” carries the risk that coverage will be terminated for some eligible beneficiaries, and CMS is rescinding that option in the new guidance. 

Under the updated policy, states can’t terminate any person determined eligible for Medicaid during the PHE, including people who failed to respond to requests for information, until the state has completed a redetermination after the PHE ends.

Before taking an adverse action toward any beneficiary, states must complete an additional redetermination that includes checking available information and data sources without contacting the beneficiary and requesting documents to obtain reliable information when eligibility cannot be renewed based on available information, according to the letter.

With the extended timeframe, CMS said states should reassess their risk-based approach to prioritizing pending work and prepare to restore routine operations after the emergency ends. Their risk-based approach should promote continuity of coverage for those eligible and limit delays in processing for those newly eligible or eligible for more comprehensive coverage.

“CMS is available to provide technical assistance to states that are working to complete pending eligibility and enrollment work within the 12-month timeframe, and we remain interested in hearing state feedback and concerns as states plan for and resume routine operations consistent with the expectations outlined in this letter,” the agency said.

Clipped from: https://www.healthcaredive.com/news/cms-extends-deadlines-for-medicaid-redeterminations-after-covid-19-public-h/605122/

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With 13K new members in Central Oregon, Medicaid will carry pandemic lessons

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Oregon is getting ready to begin the disenrollment process for those no longer eligible once the pandemic is declared over, but is hoping to make the application process easier moving forward.

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

More Oregonians than ever before are using the state’s free health care during the pandemic — but for many, that could change in a few months.

A set of changes to federal law are expiring next year, potentially causing thousands to lose their access to the Oregon Health Plan, the state’s Medicaid program, which provides health and dental benefits to low-income Oregonians.

“Enrollment in (Central Oregon) has grown since the pandemic started. That’s pretty consistent with what’s happening across the state,” said Lindsey Hopper, a vice president with PacificSource who oversaw Medicaid in Central Oregon for much of the pandemic.

In June, there were about 13,000 more people in Deschutes, Jefferson and Crook counties covered by the state’s Medicaid program than there were at the start of the pandemic last March, according to an analysis of Oregon Health Authority data.

As economic turmoil forced hundreds of thousands of layoffs statewide, more people lost their employers’ coverage and couldn’t afford their own, causing a spike in applications last spring.

But most of the increased enrollment comes from a mundane change to the annual renewal process: In the first pandemic relief package from March 2020, Congress asked states to keep Medicaid members on the rolls during the pandemic, even if their incomes rose or they missed their renewal paperwork.

“We think all of those things contribute to what happens to enrollment in the Oregon Health Plan,” Hopper said.

Oregon’s Medicaid enrollment is expected to keep growing to more than 1.4 million next summer, up from around 1.1 million prior to the pandemic.

Despite Central Oregon seeing more than a 20% increase in health plan members compared to before the pandemic, it’s actually been easier for some agencies to help people get covered during the pandemic.

“So our traffic is down, but every person we get stays on (the plan) until the end of the pandemic,” said Sean McAnulty, who supervises a small team of insurance enrollment assisters with Mosaic Medical.

McAnulty’s team helps Central Oregon residents figure out what low- or no-cost health insurance options are available to them.

Now, the continuous enrollment rules have reduced their caseload by about half.

The rules for showing proof of income were also relaxed, and the ability to work through applications over the phone has allowed Mosaic’s team to spend more time helping clients actually use their coverage once they’re enrolled.

“We’re providing a higher level of assistance as we have more time for each case,” McAnulty said. “There’s a lot of navigation after. Getting someone benefits doesn’t mean they end up using them.”

That means doing things like helping members set up their first appointments once they’re covered.

Changes on horizon

Once the pandemic ends — or, at least, the federal government’s public health emergency declaration expires — the pandemic eligibility rules go away.

That means the state will again begin reevaluating the eligibility of those on the plan, and anyone whose income has risen above the Medicaid threshold since they got on the plan or who hasn’t kept up with their paperwork will receive a notice that their coverage could expire.

“Whenever there’s going to be something like this, there’s always going to be people who fall off,” McAnulty said. “This is why we’re here, is to help people navigate that.”

Since the change is dependent on the federal declaration, precise timelines aren’t yet set in stone. Projections from the Oregon Health Authority suggest the declaration will likely expire in January 2022, and re-enrollment eligibility will be determined over the next six months .

An estimated 200,000 members statewide will lose their coverage when rules change. Some of those people will be losing coverage because they’re no longer eligible, such as if they returned to their jobs and now make more than the income requirement.

But many will be part of what Lori Coyner, Oregon’s former Medicaid director, calls the “churn population,” those who frequently are off-and-on with the state’s insurance policy as their incomes fluctuate or they miss their paperwork.

That churn, all but eliminated by the pandemic’s enrollment rules, makes it harder for people to access the health care they might be eligible for.

“We do know that when people stay on, they keep their doctors, they keep their providers, where to get their prescriptions filled and all of that,” Coyner said. “When they drop off and then come back on, they have to re-establish all of that.”

Pandemic’s impact could be here to stay

Coyner’s goal now is to avoid some of those on-and-off relationships by making some of the pandemic’s lessons permanent fixtures of the Oregon Health Plan.

It’s a perfect time: The state’s renegotiating its five-year agreement with the federal government laying out exactly how Medicaid in the state will operate outside of typical federal rules.

Coyner, now a policy advisor heavily involved in designing the agreement, said the state hopes to make permanent the pandemic provisions reducing how often people have to reapply and reducing the amount of financial paperwork they have to submit.

“We learned that it’s much faster for people to apply and get their application in, and then we can do the income verification later instead of having to have them get a check stub right at the front end,” Coyner said.

Those changes to the plan still have to be approved by the federal agency that oversees Medicaid, and wouldn’t be finalized until the new agreement takes effect next summer.

Aside from all the technical hoops temporary rules may have eliminated, the pandemic “shined a light” on disparities in access to care, added Dana Hittle, now the state’s interim Medicaid director.

“For all of the flexibilities, or a good number of the flexibilities, that we were able to put into place because of the pandemic that we want to continue,” Hittle said, “the goal is to make it as easy as possible for people to have access to health care and remove those barriers.”

Clipped from: https://www.bendbulletin.com/localstate/with-13k-new-members-in-central-oregon-medicaid-will-carry-pandemic-lessons/article_e96de250-ee35-11eb-8f51-d7280945f893.html

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Florida Medicaid enrollment tops 4.8 million, surpassing forecast growth

 
 

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Florida Medicaid enrollment continues to surge.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

The Florida State Capitol buildings (Old Capitol in foreground) in Tallahassee, Florida.  

Shutterstock photo

(The Center Square) – Florida’s Medicaid enrollment increased by 1% in June with 48,468 low-income residents qualifying for subsidized health care, according to the state’s Agency for Health Care Administration (AHCA).

As of June 30, there were 4,846,412 low-income, elderly and disabled Floridians enrolled in Medicaid, an increase of more than 730,000 since June 2020, AHCA documents in its June enrollment report.

Florida’s economy lost 1.1 million jobs during the peak of the pandemic last spring, hitting a peak unemployment rate of 14.2%.

Medicaid enrollment boosts quickly followed with more than 885,000 qualifying for full coverage between last March and this February, expanding the state’s Medicaid enrollment from 3.9 million to 4.6 million.

Since February, another 250,000 residents have qualified. In December, the Legislature’s Social Services Estimating Conference (SEC) economists forecast 4.588 million Floridians will be enrolled in Medicaid during Fiscal Year 2020 (FY22), which began July 1. That projection has already been eclipsed.

Using an economic forecasting model based on studies of post-pandemic economic recoveries, state economists project it could take 12-15 months to claw back to pre-pandemic employment levels and trim back the state’s Medicaid rolls.

The state’s $100 billion FY22 budget includes about $44 billion in health care spending largely subsidized by federal pandemic assistance, including about $34 billion for Medicaid, up from $31.6 billion the previous year.

June marked the 15th consecutive month in which Medicaid enrollment increased in Florida, the AHCA notes, and also sustained the state’s status as the nation’s leader in enrollment in subsided health insurance plans offered under the Affordable Care Act (ACA).

According to the federal Centers for Medicaid & Medicare Services’ (CMS) June Special Enrollment Period Report, 413,409 Floridians enrolled in plans available under the ACA between Feb. 15 and June 30.

Overall, about 2.3 million Floridians have purchased “Obamacare” policies, nearly 20% of the 8.5 million people nationwide who selected or were automatically re-enrolled in HealthCare.gov plans during the extended 2021 open-enrollment period, according to CMS.

After the Trump administration halved the yearly open enrollment period from 12 to six weeks in 2020, President Joe Biden signed an executive order in January authorizing a special enrollment period between Feb. 15 and Aug. 15 because of the COVID-19 pandemic.

According to the CMS, 1.5 million people in 36 states nationwide enrolled in ACA plans between Feb. 15 and June 30. Florida’s 413,409 boost accounted for 27% of that increase.

With average premiums through the ACA marketplace dipping by 25% in April with the adoption of American Rescue Plan tax subsidies, the CMS notes that 34% of new enrollees are paying $10 or less per month after tax credits are taken into account.

“When you make coverage affordable, when you make it easy for people to enroll, they will do so,” CMS Administrator Chiquita Brooks-LaSure said. “”The American Rescue Plan has made health coverage more affordable and accessible than ever – and people are signing up.”

In 2014, 983,775 Floridians signed onto the program in its first year. By 2019, 1.9 million Floridians were enrolled.

Florida’s nation-leading ACA insurance exchange enrollment is a product of the state’s growing population of more than 21 million and state lawmakers refusal to expand Medicaid. Florida is one of 12 states that has not done so.

“Let’s be clear – the monthly marketplace numbers show that across the country, there’s a demand for high-quality, low-cost health coverage,” Health & Human Services Secretary Xavier Becerra said. “Whether through expanded Medicaid or the Health Insurance Marketplace, the ACA is working for millions of Americans – and we’re committed to building on this historic progress.”

Clipped from: https://www.thecentersquare.com/florida/florida-medicaid-enrollment-tops-4-8-million-surpassing-forecast-growth/article_2fc57242-e673-11eb-8fad-e7067aadfda3.html