HHS Takes Action to Provide 12 Months of Mandatory Continuous Coverage for Children in Medicaid and CHIP

via the Centers for Medicare & Medicaid Services (CMS):

HHS Takes Action to Provide 12 Months of Mandatory Continuous Coverage for Children in Medicaid and CHIP

  • Letter sent to state health officials in all 50 states, D.C., and US territories

Today, as part of its ongoing work to make sure all Americans have access to health care coverage, the U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS), sent a letter to state health officials reinforcing that states must provide 12 months of continuous coverage for children under the age of 19 on Medicaid and the Children’s Health Insurance Program (CHIP) beginning January 1, 2024. The Biden-Harris Administration is committed to using every available lever to protect and expand coverage for children. Today’s action will help to ensure that eligible children enrolled in Medicaid and CHIP have uninterrupted coverage over the course of a year, helping children maintain access to the health care services they need to thrive.

"Children should always have access to health care services. No exceptions. Thanks to the actions taken by the Biden-Harris Administration, states must provide all children with Medicaid and CHIP continuous coverage for 12 months,” said HHS Secretary Xavier Becerra. “This important action will ensure children have access to the preventative and primary care they need to be healthy and thrive. We will continue to support children and their families, whenever and however it is needed.”

“CMS continues to work to increase access to health care services for children in ways that reduce disparities and build a reliable health safety net for every young person,” said CMS Administrator Chiquita Brooks-LaSure. “Families of children enrolled in Medicaid and CHIP will have peace of mind knowing their children will have uninterrupted access to health care coverage for a year, regardless of any changes in their family’s financial circumstances.”

Ensuring 12 months of uninterrupted health coverage for children promotes access to appropriate preventive and primary care, necessary treatment for health care needs that may arise, and continuity of care. Research has shown that children who are disenrolled for all or part of the year are more likely to have only fair or poor health status compared to children who have health coverage continuously throughout the year.[1]

Continuous coverage for children has been shown to reduce financial barriers to care for low-income families, promote health equity, and provide states with better tools to hold health plans accountable for quality care and improved health outcomes.[1]Stable coverage also enables health care professionals to develop relationships with children and their parents, track a child’s health and development, and help a family avoid expensive emergency room visits. Additionally, when families maintain coverage year-round, it reduces the administrative burden on state agencies due to repeated eligibility reviews and re-enrollment after a gap in coverage.

Today’s letter provides background on the importance of continuous coverage in preventing interruptions that impede access to health coverage to support better short- and long-term health outcomes, and describes policies related to implementing continuous coverage for children as required by the Consolidated Appropriations Act of 2023. The letter also reminds states that they may request section 1115 demonstration authority under the Social Security Act to extend the continuous coverage period for children beyond 12 months, and to adopt continuous coverage for adults eligible for Medicaid.