1-2 Policy Punch Earns Covering Kids Gold Star Status

As CCFs Medicaid child enrollment tracker hit a major milestone this week, a net decrease of 3 million children since March 2023, CMS released a package of documents advising and encouraging states to do more. yet to ensure that children do not slip through the cracks during the removal of the pandemic-related continued enrollment requirement. Considering that researchers estimate that most children will remain eligible for Medicaid or CHIP, a smaller number of children can be expected to lose coverage. But that is not the case!

However, when you look beyond the national numbers reported by CMS, you see that half of the children who lost coverage live in five states: Texas, Florida, Georgia, Ohio, and Arkansas. In fact, Texas accounts for a whopping 24% of child disenrollments based on data through September 2023 according to the Secretary’s letter. HHS sent letters to Governors in those states, as well as smaller states with high child coverage denial rates in Idaho, Montana, New Hampshire, and South Dakota saying the agency is taking the its oversight role and will not hesitate to act to ensure state compliance with federal Medicaid requirements.

In addition to placing the notice in nine states, CMS issued an informational bulletin reinforcing federal renewal and reporting requirements, and highlighting actionable strategies that everyone can use. by the state to promote continuous coverage for children and youth who are likely to remain eligible for Medicaid or CHIP. The guideline recommends that:

  • Conduct targeted outreach to children and youth with special health care needs;
  • Support seamless transitions in programs;
  • Increase ex parte renewal rates;
  • Work with managed care plans to increase outreach and renewal assistance;
  • Eliminate or suspend premiums or enrollment fees and eliminate lock-out periods following non-payment;
  • Delay or pause disenrollment procedures;
  • Strengthen outreach to families and strengthen partnerships with family-serving agencies and community-based organizations.

But what really caught our eye was CMS encouraging states to take advantage of multiple years of continued eligibility for children through section 1115 showing authority, as Oregon, Washington and New Mexico have done and eight other states are quickly pursuing. In fact, we will propose a 1-2 punch to help states deal with the ongoing challenges of operational unwinding and protect children’s coverage at the same time.

Punch 1 will take advantage of an available Section (e)(14) waiver to push back children’s renewal dates by one year as offered by CMS when the ex parte the household mistake was revealed in August. Kentucky and North Carolina are the first states to take this option. Because children will represent 46 percent of all Medicaid enrollees in March 2023, delaying children’s renewals will free up too many systems and eligibility workers to focus on renewing coverage. for adults and frail seniors and people with disabilities.

Punch 2 implement multi-year continuous eligibility for children, especially young children in the critically important early years, protecting them from inappropriate coverage terminations that are particularly acute on renewal even if they remain eligible. When multi-year continuity takes effect, those children are protected until they reach the higher age range. For example, Oregon, Washington, and New Mexico continue to cover children until their sixth birthday while Oregon also covers older children for two years rather than the 12-month continuous eligibility that applies to all children on Medicaid starting in 2024.

North Carolina is in line to become the first state to take advantage of the 1-2 punch. As mentioned above, the state has already received approval to push the renewal dates for children 12 months. And in its Section 1115 waiver application pending with CMS, the state proposes to implement multi-year continuous eligibility for young children up to age six later in 2024.

As we close out 2023, Governors and state leaders must think about the negative impacts of children losing access to the health insurance they need to thrive. The long-term benefits of Medicaid coverage during childhood are well documented, including better health, higher education, greater income, and lower incidence of disability later in life. Covering young children from birth until they enter school is particularly important in addressing developmental delays that can hinder school performance and lead to increased special education costs. Every child should have the opportunity to thrive, and Governors can earn a gold star (not to mention winning favor with the voting public) for advancing to protect children’s health care. The country has made tremendous progress in reducing the number of uninsured children over the past two decades; now Governors are at a critical moment when state choices will result in more children going uninsured or, states will transition to a new normal where children can access care without interruption their parents in red tape.

Editors’ note: There was a delay in CMS reporting state-level data accounting for differences in the CCF enrollment tracker showing a decline of 3 million children compared to the 2.2 million decline reported by CMS through September 2023 .CCFs tracker includes more current state-reported enrollment data.

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Image Source : ccf.georgetown.edu

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