Managing Medicaid Program Size Post-Emergency Challenges
Right-sizing Medicaid
after the Public Health Emergency
CSG Medicaid Academy | Sept. 14, 2022
Non-profit association for the 56
state and territorial Medicaid leaders
Our mission: help Medicaid leaders
deliver high value services to
millions served by the program
NAMD’s three core functions
Thought leadership
Building federal/state partnership
Providing program assistance and
leadership development
NAMD
1.
Medicaid as a “first responder”
2.
Right sizing the program after
the emergency
3.
Takeaways for state
policymakers
Overview
Medicaid as a First Responder
●
Medicaid is designed to help the
nation through crises, like the
pandemic
●
As a condition of receiving enhanced
federal funding, Medicaid programs
employed “continuous coverage”
●
No one who was enrolled lost
coverage
●
Enrollment grew from roughly 71 m
to more than 88 m adults and
children
●
Projected to cover 1 in 3 Americans by
Sept. 2022
Medicaid as a
First Responder
Medicaid and CHIP Enrollment Growth
February 2020 – April 2022
Source:
Kaiser Family Foundation
Enrollment Growth by State
February 2020 – April 2022
Source:
Kaiser Family Foundation
Right Sizing the Program after the
Emergency
●
When the federal health emergency
ends, Medicaid must redetermine
eligibility for every individual
●
An estimated 15 m people may lose
their Medicaid or CHIP coverage
○
8.2 m may be eligible for other
sources of health insurance
○
6.8 m may lose coverage for
administrative or procedural
reasons
Right Sizing the
Program
Core challenges involved
●
Coverage continuity
●
“Churn” or coverage loss for
administrative reasons
●
Operational realities
●
Budget implications
Right Sizing the
Program
Operational Realities
●
Navigating federal flexibilities and
authorities
●
Making IT system changes
●
State and county workforce
readiness
●
Outreach and communications
Right Sizing the
Program
Budget Implications
●
Loss of enhanced funding at end
of quarter in which emergency
ends
●
Caseloads will remain high for 12+
months after emergency ends
●
No additional funding for
administrative costs of unwinding
Right Sizing the
Program
Takeaways for Policymakers
●
Ensure Medicaid is appropriately
resourced.
State and county workforce
capacity is particularly important.
●
Recognize federal uncertainty
. We don’t
know when this work will begin, and
federal rules of the road may change.
●
Support awareness and communications.
Help us get the right messages out at the
right time.
●
Help us through the road bumps.
We’re in
uncharted territory, and your partnership
will be key to our success.
Takeaways for
Policymakers
Medicaid, a crucial responder during public health crises, faces challenges post-emergency in right-sizing the program. As the federal health emergency ends, millions may lose coverage, prompting the need for eligibility redetermination. State policymakers must navigate enrollment fluctuations to ensure continued access to healthcare for vulnerable populations.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Right-sizing Medicaid after the Public Health Emergency CSG Medicaid Academy | Sept. 14, 2022
Non-profit association for the 56 state and territorial Medicaid leaders NAMD Our mission: help Medicaid leaders deliver high value services to millions served by the program NAMD s three core functions Thought leadership Building federal/state partnership Providing program assistance and leadership development
Overview 1. Medicaid as a first responder 2. Right sizing the program after the emergency 3. Takeaways for state policymakers
Medicaid is designed to help the nation through crises, like the pandemic Medicaid as a First Responder As a condition of receiving enhanced federal funding, Medicaid programs employed continuous coverage No one who was enrolled lost coverage Enrollment grew from roughly 71 m to more than 88 m adults and children Projected to cover 1 in 3 Americans by Sept. 2022
Medicaid and CHIP Enrollment Growth February 2020 April 2022 Source: Kaiser Family Foundation
Enrollment Growth by State February 2020 April 2022 Source: Kaiser Family Foundation
Right Sizing the Program after the Emergency
When the federal health emergency ends, Medicaid must redetermine eligibility for every individual Right Sizing the Program An estimated 15 m people may lose their Medicaid or CHIP coverage 8.2 m may be eligible for other sources of health insurance 6.8 m may lose coverage for administrative or procedural reasons
Core challenges involved Coverage continuity Right Sizing the Program Churn or coverage loss for administrative reasons Operational realities Budget implications
Operational Realities Navigating federal flexibilities and authorities Right Sizing the Program Making IT system changes State and county workforce readiness Outreach and communications
Budget Implications Loss of enhanced funding at end of quarter in which emergency ends Right Sizing the Program Caseloads will remain high for 12+ months after emergency ends No additional funding for administrative costs of unwinding
Ensure Medicaid is appropriately resourced. State and county workforce capacity is particularly important. Takeaways for Policymakers Recognize federal uncertainty. We don t know when this work will begin, and federal rules of the road may change. Support awareness and communications. Help us get the right messages out at the right time. Help us through the road bumps. We re in uncharted territory, and your partnership will be key to our success.
