December 18th 2023.
HHS Secretary Xavier Becerra is advocating for states with the highest rates of children who have been dropped from Medicaid to make use of certain federal rules that can help get families back on coverage. On Monday, Becerra sent letters to governors of Arkansas, Florida, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota and Texas, urging them to take advantage of options provided by CMS.
Becerra is asking states to employ strategies such as auto-renewing coverage with information already on file, and providing an extra 12 months for kids to get on the rolls, an option that is available until 2024. He is also encouraging states to remove any barriers to enrollment for children no longer eligible for Medicaid and reduce call center times for families.
The Secretary wrote, “Because all children deserve to have access to comprehensive health coverage, I urge you to ensure that no child in your state who still meets eligibility criteria for Medicaid or CHIP loses their health coverage due to ‘red tape’ or other avoidable reasons as all states ‘unwind’ from the Medicaid continuous enrollment provision that was in place during much of the COVID-19 public health emergency.”
HHS reports that the nine states combined are responsible for 60 percent of children’s coverage losses between March and September. CMS Administrator Chiquita Brooks-LaSure said, “State choices matter. States that have taken up the historic number of new policy flexibilities that CMS has put on the table are better able to protect kids' coverage.”
In response to HHS, spokespeople from Florida, Georgia and Texas claimed that the states have done their best to manage the unwinding process. Mallory McManus from Florida's Department of Children and Families wrote, “A reminder that the Medicaid redetermination process is simply setting normal operations back in motion, like how it was before the pandemic, to ensure those accessing a safety net program in our state are those who truly qualify.” Tiffany Young from the Texas health department said the state meets regularly with federal partners and staggered the unwinding over several months. Garrison Douglas from Georgia's governor's office said the Biden administration “once again missed an opportunity to urge families to fill out their paperwork.”
The new HHS data provides insight into the unwinding process. In the 10 states that have not expanded Medicaid, disenrollments among children are higher than in states that have expanded Medicaid combined. This is in part due to the fact that expansion states have taken up more CMS flexibilities. In non-expansion states, 27.6 percent of disenrollments are due to youth turning 19 during the Covid-19 public health emergency, compared with 12.1 percent of disenrollments in expansion states.
In August, HHS sent letters to all states warning that they might be running afoul of federal requirements. In September, CMS said half a million people had mistakenly lost coverage due to errors by the states. The states were then told to pause disenrollments and reinstate individuals who had lost coverage or face losing federal funding.
Arkansas, Idaho, Montana, New Hampshire, Ohio and South Dakota did not return requests for comment. Ultimately, it is important to ensure that no child in any state loses coverage due to avoidable reasons. It is up to the states to take up the new policy flexibilities put in place by CMS, and to urge families to fill out the necessary paperwork.
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