Our organizations, representing hundreds of millions of patients and consumers facing serious, acute, and chronic health conditions across this country, urge you to take additional actions to protect patients’ access to Medicaid and Children’s Health Insurance Program (CHIP) coverage over the coming months.
Beginning in April 2023, states resumed Medicaid eligibility determinations paused during the COVID-19 public health emergency. Data reported by states has shown that, as of January 2024, more than 15 million people have lost Medicaid coverage and more than 70% of coverage terminations have been for procedural reasons, such as being unable to locate individuals or not receiving re-enrollment paperwork on time. Our organizations have heard stories from patients who have spent multiple hours on hold with call centers to try to resolve coverage issues, never received required renewal paperwork and learned of their coverage loss at the pharmacy counter, and followed instructions to submit information to Medicaid and still learned they lost their coverage when checking in for surgery at the hospital. We are deeply concerned about these data and reports.
In December 2023, the US Department of Health and Human Services released additional data identifying states where large numbers of children are losing Medicaid coverage and an informational bulletin focused on ensuring eligible children maintain Medicaid and CHIP coverage. Any significant Medicaid loss for children during unwinding is very troubling because the majority of children remain eligible and are at high risk of becoming uninsured.
Our organizations strongly urge you to take additional action to protect coverage for the children and families we represent over the next year by:
- Employing the (e)(14) strategy to pause renewals for children for an additional 12 months to prevent procedural disenrollments of eligible children. Kentucky and North Carolina have already adopted this policy, which allows states to focus on adults and people with disabilities during the current unwinding process by reducing their workload significantly.
- Using this extension period to implement additional policies that will reduce churn in Medicaid, protecting coverage and minimizing the administrative burden on state Medicaid programs. We specifically encourage states to pursue Section 1115 waivers to adopt continuous eligibility for adults and multi-year continuous eligibility for children 0-6.
- Working to improve your state’s rate of ex parte renewals and reducing procedural coverage terminations. The Administration has confirmed that (e)(14) flexibilities will be available at least through the end of 2024.
- Investing in increased staffing to process redeterminations and provide assistance to consumers in a timely manner, as well as investing in robust public education campaigns to reach people who lost coverage for procedural reasons and help them enroll in Medicaid or other quality, affordable healthcare coverage.
Thank you for considering these recommendations. Our organizations are committed to working with you to ensure that those who are currently enrolled in Medicaid maintain their coverage if eligible or transition to other forms of quality, affordable care.