|
This article originally appeared in Inside Health Policy on July 3, 2024. While the Congressional Budget Office adjusted its prediction and now says more beneficiaries will retain Medicaid once the unwinding period ends, KFF’s analysis still shows more than 23 million enrollees have lost coverage since the process began April 1, 2023 and nearly 70% of those disenrollments were due to administrative reasons. Despite these dismal numbers, stakeholders are encouraged by the changes states have made to the redetermination process, including simplifying their Medicaid renewals forms, expanding beneficiary outreach methods and increasing their automated renewal rates. Many states will not be returning to their pre-pandemic Medicaid redetermination operations, KFF's annual survey of state Medicaid found.
But there’s more lawmakers and the administration can do to improve the accuracy and efficiency of Medicaid determinations, says the Connecting to Coverage Coalition, which is comprised of providers, insurers and beneficiary advocates. “Congress should permanently extend the ACA premium tax credits and policy changes to ensure that eligible individuals and families may continue to enroll in comprehensive insurance coverage through the federal Marketplace and state exchanges, promoting continuous access to quality, affordable coverage for prescription drugs, treatments, and other health care services,” CCC lists as one of its recommendations in a recent report. CCC also wants to see CMS promote more opportunities to streamline enrollment and reduce the administrative burden on Medicaid enrollees who are moving onto other federal programs like the marketplace or the Children’s Health Insurance Program. Meanwhile, CCC says CMS should make permanent its unwinding flexibilities meant to boost the effectiveness of ex parte, also known as automatic, renewals. Automatic renewals are where states use a third party to confirm ongoing eligibility rather than going directly to the beneficiary for additional information. Specifically, stakeholders think the administration should continue the ability for states to: check Supplemental Nutrition Assistance Program or Temporary Assistance for Needy Families for a beneficiary’s income; automatically renew coverage of beneficiaries who qualified for $0 income and continue to show no recent income data; and continue eligibility for older or disabled Medicaid beneficiaries whose asset information is not returned within a reasonable time frame. States should also be permanently allowed to renew eligibility without checking other data sources when the enrollee’s income is from stable sources, like Social Security payments, pension income or life insurance policies. While CMS announced states will be required to continue reporting on certain Medicaid enrollment and renewals beyond the unwinding, CCC says CMS should focus on collecting data for certain populations to provide additional context. This includes children; individuals dually enrolled in Medicaid and Medicare; pregnant and postpartum women; enrollees who are aged, blind or disabled; those whose preferred language is not English; and beneficiaries whose coverage was reinstated after being terminated during the unwinding. Comments are closed.
|
