Medicaid Unwinding

via the Maryland Insurance Administration:

The national COVID-19 Public Health Emergency is scheduled to end on May 11, 2023.

What does that mean for your health insurance coverage? Here is what to expect with regard to COVID-19 Testing, Vaccinations, and Treatments.

COVID-19 TESTING:

via the NJ Dept. of Banking & Insurance:

New Jersey Department of Banking and Insurance Establishes Extended Special Enrollment Period at Get Covered New Jersey for Individuals Losing NJ FamilyCare Coverage

TRENTON – New Jersey Department of Banking and Insurance Commissioner Marlene Caride today announced the creation of an extended Special Enrollment Period for individuals who are no longer eligible for NJ FamilyCare and qualify for health insurance through Get Covered New Jersey, the state’s Official Health Insurance Marketplace.

Per federal law, the Department of Human Services is restarting eligibility reviews for NJ FamilyCare as of April 1, which will result in some individuals who are no longer eligible being disenrolled from the program. For those who no longer qualify for NJ FamilyCare because their income is too high, they may be eligible to obtain health coverage through Get Covered New Jersey and may be able to get help paying for premiums.

via the Washington Health Benefit Exchange:

Apple Health (Medicaid) renewal letters have begun mailing

The Washington State Health Care Authority (HCA), Washington Health Benefit Exchange (Exchange), and the Department of Social and Health Services (DSHS) have begun mailing letters to Washington Apple Health (Medicaid) clients reminding them to update their contact information and renew coverage to see if they still qualify.

For the first time in over three years, people on Apple Health could lose coverage if their family income has gone up. Federal requirements during the COVID-19 public health emergency (PHE) led to income checks being suspended to keep clients enrolled in Apple Health during the pandemic. However, last December’s federal omnibus spending bill directed states to resume evaluating eligibility of Medicaid enrollees on April 1 to wind down COVID-19 pandemic emergency measures.

via Nevada Health Link:

First Wave of Nevada Medicaid Redeterminations Happening Now

• Those who lose health coverage through Medicaid can look for plans on NevadaHealthLink.com

(CARSON CITY, Nev.) – As the state unwinds from the federal public health emergency, the Division of Welfare and Supportive Services (DWSS) has begun the reevaluation of all Medicaid enrollments for the first time since 2020 during which you may lose coverage under Medicaid. In April, the first wave of recipients received their renewal packets in the mail. Those who did not respond or who no longer qualify based on income or other factors will lose their benefits starting June 1, 2023. Nevada Health Link is available as the go-to resource to help people stay insured.

Back in January, I noted that total enrollment in healthcare policies either specifically created by or expanded to more people by the Affordable Care Act had broken 40 million Americans:

With last week's report from the Centers for Medicare & Medicaid Services (CMS) touting the record-breaking 16.3 million Qualified Health Plan (QHP) selections during the 2023 Open Enrollment Period (OEP), it's time to take another look at the grand total.

For this, I'm assuming a similar 94% average effectuation rate as of February 1st (2 days from now) to the ASPE report from last year for QHP enrollees. Taken literally, that would mean 15,328,061 effectuated on-exchange ACA enrollees.

About a year ago, I noted that the state of Oregon had passed a bill which, if the federal waiver is approved by the federal government, would make them the third state in the U.S. to establish a Basic Health Plan program under the Affordable Care Act. As reported by Megan Messerly of Politico at the time:

In Oregon, Democrats passed a bill in March to establish a basic health program, the details of which are being ironed out by a task force that began meeting this week. In Kentucky, Republicans approved $4.5 million in state funds this spring to set up a basic health program, which was signed into law by the state’s Democratic governor. An estimated 85,000 Oregonians and at least 37,000 Kentuckians will be eligible to enroll in the plans as soon as next year.

via NY State of Health:

• Enrollment Assistors Attend YMCA Kids Day Events Throughout the State to Help Consumers Renew or Enroll in Health Coverage

• Eligibility Redeterminations will be Resuming for Over 9 Million New Yorkers in Medicaid, Child Health Plus and the Essential Plan  

ALBANY, N.Y. (April 27, 2023) – NY State of Health, the state’s official health plan Marketplace, today announced it will participate in the YMCA’s annual Healthy Kids Day, a national initiative featuring free community events with family-friendly activities that promote wellness. Certified enrollment assistors will be available at select YMCAs statewide on April 29, 2023, to provide free help to New Yorkers. They will provide information about upcoming changes to their health insurance, answer questions about renewals, and provide information to uninsured New Yorkers about enrolling in coverage through the Marketplace.  

via NY State of Health:

• As Eligibility Redeterminations Resume, New York Gets Ready to Renew Coverage for Over 8 Million Enrollees in Medicaid, Child Health Plus and the Essential Plan

• Enrollment Assistors Available at Kinney Drugs, ShopRite and Rite Aid to Educate Consumers About Insurance Through the Marketplace

ALBANY, NY (April 26, 2023) – NY State of Health, the state’s official health plan Marketplace, is teaming up with retail pharmacies across the state to educate New Yorkers enrolled in public health insurance programs about upcoming changes to their coverage. With federal rules now requiring the state to resume eligibility redeterminations for nearly 9 million enrollees in Medicaid, Child Health Plus and the Essential Plan this spring, the Marketplace is increasing outreach to ensure consumers don’t risk a gap in their coverage. Certified enrollment assistors will be available on-site at pharmacies to answer current enrollees’ questions about renewals, as well as provide information to uninsured New Yorkers about enrolling in health insurance through NY State of Health. 

via the Maine Dept. of Health & Human Services:

Individuals losing eligibility for MaineCare can enroll in plans on CoverME.gov through July 31, 2024

AUGUSTA— The Maine Department of Health and Human Services (DHHS) announced today the launch of a Special Enrollment Period (SEP) through CoverME.gov, Maine’s Health Insurance Marketplace, to help Maine people transitioning from MaineCare coverage after the COVID-19 pandemic explore affordable health insurance options and avoid gaps in coverage. The Special Enrollment Period began on April 15, 2023, and will continue through July 31, 2024, allowing Maine individuals found no longer eligible for MaineCare to apply for plans through CoverME.gov outside of the annual Open Enrollment Period.

via Access Health CT:

Agencies share plan to address HUSKY Health eligibility, redeterminations and enrollment actions

HARTFORD, CT (March 27, 2023) — The Department of Social Services (DSS) and Access Health CT (AHCT) today shared a comprehensive 12-month operational and outreach plan to redetermine eligibility for HUSKY Health enrollees and resume routine public program operations. HUSKY Health is Connecticut’s Medicaid program.

Prior to the pandemic, annual redeterminations of eligibility for the Medicaid program occurred on a monthly basis during the year and terminations were processed for individuals no longer eligible for the program. During the pandemic, the termination process was paused. The federal government passed legislation, known as the Consolidated Appropriations Act of 2023, that now requires the monthly redeterminations to begin again as of March 31.