PHE

Yesterday I noted that the big year-end federal omnibus spending bill includes provisions which allow states to start kicking people off of Medicaid who are only eligible thanks to the COVID-19 public health emergency bills passed in 2020 & 2021..but it at least does so in a fairly responsible way by phasing out the extra federal matching funds gradually over a 9-month period, to prevent states from dumping everyone all at once.

The omnibus bill also includes other important positive Medicaid provisions such as letting children who are eligible for the program stay on it for at least 12 months regardless of  household income changes, and letting states offer 12 months of postpartum Medicaid/CHIP coverage to newborn children & their mothers on a permanent basis instead of the current 5-year limit.

As I (and many others) have been noting for over a year now, the official end of the federal Public Health Emergency (PHE), whenever it happens, will presumably bring with it reason to celebrate...but will also likely create a new disaster at the same time:

What goes up usually goes back down eventually, and that's likely to be the case with Medicaid enrollment as soon as the public health crisis formally ends...whenever that may be.

Well, yesterday Ryan Levi and Dan Gorenstein of of the Tradeoffs healthcare policy podcast posted a new episode which attempts to dig into just when that might be, how many people could be kicked off of the program once that time comes and how to mitigate the fallout (I should note that they actually reference my own estimate in the program notes):

Outline of Puerto Rico

via the Centers for Medicare & Medicaid Services:

The Centers for Medicare & Medicaid Services announced today additional resources and flexibilities available in response to Hurricane Fiona in the commonwealth of Puerto Rico.  CMS is working closely with the Commonwealth of Puerto Rico to put these flexibilities in place to ensure those affected by this natural disaster have access to the care they need – when they need it most.

On September 18, 2022, President Biden determined that an Emergency exists in the Commonwealth of Puerto Rico due to the emergency conditions resulting from the then Tropical Storm Fiona beginning on September 17, 2022, and continuing.  Additionally, on September 20, 2022, Department of Health and Human Services Secretary Xavier Becerra determined that a Public Health Emergency exists in the Commonwealth of Puerto Rico and has existed since September 17, 2022.

CMS stands ready to assist with resources and waivers to ensure hospitals and other facilities can continue to operate and provide access to care to those impacted by the consequences of the hurricane.

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