Managing Medicaid Program Size Post-Emergency Challenges
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.
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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.
