The Biden-Harris Administration today unveiled a final rule that will protect and improve how millions of eligible people apply for, renew, and maintain health care coverage through Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). The Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes rule will remove red tape and barriers to enrollment, update and build on the Affordable Care Act’s (ACA’s) coverage protections and ensure that millions of Americans can get and keep their coverage. With this rule, millions of Americans will benefit from a modernized, less cumbersome enrollment process with reduced red tape, helping more people keep coverage.
HHS Extends Special Enrollment Period to Help People Transition to the Marketplaces, Issues New Resources for Partners, and Publishes Guidance Reinforcing Key Federal Requirements
In December 2023, 85,094,448 individuals were enrolled in Medicaid and CHIP, a decrease of 785,863 individuals (0.9%) from November 2023
77,913,798 individuals were enrolled in Medicaid in December 2023, a decrease of 786,068 individuals (1.0%) from November 2023.
7,180,650 individuals were enrolled in CHIP in December 2023, an increase of 205 individuals (0.0%) from November 2023.
As of December 2023, enrollment in Medicaid and CHIP has decreased by 8,773,558 individuals (9.3%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
Medicaid enrollment has decreased by 8,816,761 individuals (10.2%).
CHIP enrollment has increased by 43,203 individuals (0.6%).
Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,992,937 individuals (32.4%) to 93,868,006.
Medicaid enrollment increased by 22,6350,766 individuals (35.3%).
CHIP enrollment increased by 342,171 individuals (5.0%).
Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.
However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.
As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.
New Jersey Department of Banking and Insurance Acting Commissioner Justin Zimmerman today announced an expanded 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. The expanded Special Enrollment Period will be available to anyone who lost NJ FamilyCare coverage due to resumption of eligibility reviews regardless of the date they lost coverage. Previously, individuals had 120 days to enroll after their NJ FamilyCare coverage ended.
As required by federal law, the Department of Human Services restarted eligibility reviews for NJ FamilyCare on April 1, 2023. Those who no longer qualify for NJ FamilyCare because their income is too high may be eligible to obtain health coverage through Get Covered New Jersey and may be able to get help paying for premiums.
Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced Utah’s extension of comprehensive coverage for postpartum individuals for a full 12 months through Medicaid and the Children’s Health Insurance Program (CHIP).
In November 2023, 85,815,827 individuals were enrolled in Medicaid and CHIP, a decrease of 1,503,283 individuals (1.7%) from October 2023.
78,710,401 individuals were enrolled in Medicaid in November 2023, a decrease of 1,523,107 individuals (1.9%) from October 2023.
7,105,426 individuals were enrolled in CHIP in November 2023, an increase of 19,824 individuals (0.3%) from October 2023.
As of November 2023, enrollment in Medicaid and CHIP has decreased by 8,034,913 individuals (8.6%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
Medicaid enrollment has decreased by 8,007,036 individuals (9.2%).
CHIP enrollment has decreased by 27,877 individuals (0.4%).
Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,975,671 individuals (32.4%) to 93,850,740.
Medicaid enrollment increased by 22,637,644 individuals (35.3%).
CHIP enrollment increased by 338,027 individuals (5.0%).
Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.
However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.
As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.
February 23: CMS approved a postpartum coverage extension state plan amendment (SPA) for Alaska (link to come). This SPA approval will extend comprehensive coverage after pregnancy through Medicaid and the Children’s Health Insurance Program (CHIP) for a full 12 months. The approval of Alaska’s SPA marks critical progress in implementing the CMS Maternity Care Action Plan, which supports the Biden-Harris Administration’s Maternal Health Blueprint, a comprehensive strategy aimed at improving maternal health, particularly in underserved communities. Alaska is the 44th state, including D.C. and the U.S. Virgin Islands that have extended postpartum Medicaid coverage to a full year, made possible by President Biden’s American Rescue Plan (ARP), and made permanent by the Consolidated Appropriations Act, 2023 (CAA, 2023), which President Biden signed into law in December 2022.
February 16: CMS approved coverage expansions in Arizona through an amendmentof two policies, “Parents as Paid Caregivers” (PPCG) and “KidsCare Expansion." Approval of the Parents as Paid Caregivers amendment will allow the state to continue to reimburse legally responsible parents for providing direct care to their minor children, helping to mitigate the direct care worker shortage and improve access to timely, effective care in the home and community.
Additionally, the KidsCare Expansion amendment will allow the state to increase the Children’s Health Insurance Program (CHIP) eligibility thresholds from 200% of the federal poverty level (FPL) to 225% of the FPL. Expanding KidsCare is expected to improve the rate of child health insurance coverage, increase access to affordable health care coverage, decrease costs by addressing health needs earlier, when care is less expensive, and provide financial relief for families. The demonstration will remain in effect until September 30, 2027.
