The ‘Massive’ Task Awaiting State Medicaid Agencies

From Route Fifty, March 23, 2022

The end of a public health emergency would mean states losing hundreds of billions in funding for the health care program, and verifying whether millions of enrollees are still eligible.

State Medicaid officials around the country are growing increasingly worried about the mammoth and high stakes task of reevaluating who among roughly 80 million people will still be eligible for Medicaid when the Biden administration declares the national Covid-19 public health emergency to be over—a move expected in July.

With health advocates and state officials acknowledging a lot could go wrong, they are worried people will be mistakenly thrown off of the program, which provides health coverage to low-income Americans.

“It’s a pretty massive undertaking for us,” Nicole Comeaux, New Mexico’s Medicaid director said in an interview. “Really our goal is that everybody stays in the coverage who are eligible for it.”

On top of that challenge, state officials face added pressure because the end of the public health emergency, which began in January 2020, would mean roughly $90 billion a year in increased federal Medicaid funding states have been receiving would suddenly screech to a halt. That could happen as soon as the end of September.

Earlier in the pandemic, Congress and the Trump administration increased the federal government’s share of paying for Medicaid, known as the Federal Medical Assistance Percentage, or FMAP, by 6.2%. The move was a response to people losing health care coverage from their jobs in the early days of the pandemic.

In return for getting the extra money, approved in the March 2020 pandemic relief law known as the Families First Coronavirus Response Act, states were barred from removing anyone from their Medicaid rolls.

Meanwhile, the number of people enrolled in Medicaid and the related Children’s Health Insurance Program grew from 70.7 million in February 2020 to 84.8 million last September, according to federal figures.

When the public health emergency ends, Medicaid offices will have to return to determining whether everyone on the rolls is eligible—except with a lot more people to check compared to before the pandemic.

Recognizing the size of the task, the Centers for Medicare & Medicaid Services in March gave states up to 14 months after the end of the emergency declaration to reevaluate enrollees. But the rub for state budgets is that the increased federal help will have disappeared long before the end of those 14 months.That means it could make sense for them to get their Medicaid rolls in order ahead of the deadline.