Capitol Correspondence - 09.26.23

500,000 Children and Families Regain Medicaid and CHIP Coverage

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In an announcement last week, the U.S. Department of Health and Human Services (HHS) revealed that the Centers for Medicare & Medicaid Services (CMS) has restored Medicaid and Children’s Health Insurance Program (CHIP) coverage to approximately half a million children and families. The initiative comes after CMS sent a letter to call on states to address a systems issue where individuals, including children, were inappropriately disenrolled from Medicaid and CHIP, despite maintaining their eligibility. 

CMS’ response to the issue led to the reinstatement of coverage for nearly 500,000 individuals who had been improperly disenrolled from these crucial health care programs. Furthermore, the actions taken are expected to prevent future improper disenrollments, offering protection to countless more beneficiaries. 

The letter, delivered to all states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, required them to investigate and report on any systems issue that led to unwarranted disenrollments. As of the latest summary, 30 states have acknowledged the existence of this systems issue. To prevent further intervention by CMS, all 30 states were mandated to halt procedural disenrollments for affected individuals unless they could guarantee that no eligible beneficiaries would be erroneously disenrolled due to this problem. 

HHS Secretary Xavier Becerra emphasized the commitment of HHS to ensure that people have access to affordable and high-quality health insurance, whether through Medicare, Medicaid, the Marketplace, or employer-based coverage. He expressed gratitude for the swift action taken, which will reinstate coverage for numerous individuals and provide ongoing protection. 

CMS Administrator Chiquita Brooks-LaSure underscored the critical role played by Medicaid and CHIP in the lives of millions of individuals and families across the nation. Addressing the systems issue was deemed a crucial step in helping eligible beneficiaries retain their Medicaid and CHIP coverage during the renewal process, particularly for children. CMS remains dedicated to ensuring that people have the healthcare coverage they require. 

CMS’ letter on August 30 alerted states to the potential eligibility systems issue associated with automatic renewals for Medicaid and CHIP coverage. Auto-renewals are a vital tool for states to retain eligible individuals in these programs during renewals, using existing reliable data sources. They simplify the renewal process, ensuring that eligible individuals do not lose coverage due to administrative challenges. 

Throughout the renewal process, CMS has provided states with strategies to make renewing coverage more accessible. Most states have adopted some of these strategies, with CMS encouraging others to follow suit. Additionally, CMS has launched national marketing campaigns and introduced special enrollment periods to facilitate transitions from Medicaid to other healthcare options in all states.