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The Health and Human Services Department announced new flexibilities for states to use during the Medicaid redeterminations process, as Secretary Xavier Becerra expressed concern at the number of enrollees removed from the program.
The expanded flexibilities allow managed care plans to assist beneficiaries with enrollment, including with filling out some of the renewal forms, and enable state Medicaid agencies to pause an administrative termination for one month to allow for more outreach to individuals. Pharmacies and community-based organizations will also be allowed to assist those who lost coverage due to administrative reasons with re-enrollment.
“I am deeply concerned with the number of people unnecessarily losing coverage, especially those who appear to have lost coverage for avoidable reasons that State Medicaid offices have the power to prevent or mitigate,” Becerra said in a letter issued to state governors Monday.
The first states began the massive undertaking of redetermining the eligibility of more than 90 million Medicaid beneficiaries two months ago. As of Monday, at least 1,027,000 Medicaid enrollees have lost coverage, according to the Kaiser Family Foundation.
HHS and the Centers for Medicare and Medicaid Services have previously cautioned state Medicaid agencies about removing too many eligible enrollees from the rolls, pointing to available flexibilities such as a 90-day special enrollment period for anyone who loses coverage during the process, and enrollment and renewal based on Supplemental Nutritional Assistance Program and Temporary Assistance for Needy Families eligibility. State Medicaid agencies are also required by federal law to automatically renew as many beneficiaries based on available data sources as possible, known as ex parte renewals.
“Nobody who is eligible for Medicaid or the Children’s Health Insurance Program should lose coverage simply because they changed addresses, didn’t receive a form, or didn’t have enough information about the renewal process,” said Becerra in a news release. “We encourage states to utilize all available flexibilities to ensure children and families don’t lose coverage. We also urge states to join us in partnering with local governments, community organizations, and schools to reach people eligible for Medicaid and CHIP where they are.”
The National Association of Medicaid Directors, representing Medicaid programs across 56 states and territories, also came out in support of the agency’s call for governors to take further action to retain coverage for the beneficiaries who are still eligible.
“We join our federal partners in agreeing that we need more help from health care providers, community advocates, clergy and employers, to help us overcome this central challenge in this historically unprecedented effort. We also urge all interested parties to help us to promote two key messages: 1) that members must engage in the eligibility process; and 2) that Medicaid coverage for eligible people, unlike private coverage, can always be restored at any point, on a rolling basis,” said NAMD Executive Director Kate McEvoy in an emailed statement.
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