Health Exchange Open Enrollment

Open enrollment in most states ended on January 15th. A record 14.5 million Americans signed up for health insurance on the federal and state health exchanges for the 2022 enrollment period.

California, Kentucky*, New Jersey, New York, Rhode Island and Washington DC extended enrollment until the end of January. (*The Kentucky extension has special requirements.)

Public Health Emergency

The Public Health Emergency (PHE) was renewed to extend through April 16th, but CMS advised the states will receive a 60-day notice prior to ending the PHE. As of February 15th, that notice has not been received

Medicaid State of the Union


On December 29, 2021, CMS sent a letter to the state approving their request for the 1115 waiver titled California Advancing and Innovating Medi-Cal (CalAIM). The waiver is designed to assist with whole-person care that includes vulnerable populations such as the homeless, those with behavioral health concerns and children with complex medical conditions.

As the state is preparing for the legislative sessions, Governor Newson has developed a bill that if passed would cover 700,000+ more people on MediCal. A large portion of that population are those who do not have Medicaid due to their immigration status.


To help with the estimated 500,000-530,000 Medicaid recipients who may need to be renewed when the PHE is over, the state is leveraging telephonic signatures, making many upgrades to their PEAK renewal module, implementing an intelligent character redesign (ICR), enhancing the Health First Colorado App, bringing stakeholders into the loop and implementing upfront income verification.

The state has also passed HB1198 which provides a new state-run Hospital Discount Care Program. The law requires hospitals to screen all uninsured patients for a government assistance program, offers new rules on how payment plans are administered and gives guidelines on sending a person to collections. The law will fully implement June 1st.


The Agency for Health Care Administration (AHCA) submitted a 36.5-billion-dollar budget request that is now sitting with the House Health Care Appropriations Committee for consideration. Much of that budget proposal is allotted for Medicaid rate adjustments and Medicaid hospital direct provider payment, among several other areas in need of funding. 


On December 23, 2021, CMS sent a letter to the state advising they are officially withdrawing the approval of the work requirement and premium policy that was originally approved by the Trump administration.

In January, the state filed a lawsuit against CMS alleging the law was violated since the federal government pulled back on a previously approved waiver.

Additionally, the Senate unanimously approved extending Medicaid coverage for pregnant women from six months to a year postpartum.


Although Missouri voters approved Medicaid expansion through a ballot initiative, legislation voted against funding for the new program. A lawsuit was filed [RL1] and ultimately sent to the Missouri Supreme Court who ruled in favor of Medicaid expansion.

The state was ordered to begin accepting applications in August, but was not able to process or approve them until October.

Recently, a Missouri House committee approved a proposed amendment that lawmakers could make annual changes on how Medicaid is funded. This could also reduce funding for Medicaid expansion and include requirements for recipients to have employment.


In January, the state started offering four Managed Medicaid plans for recipients to choose from.

New Hampshire

New Hampshire is planning for the re-determination of their Medicaid population, but it cannot do so until the Public Health Emergency ends. State officials estimate once the PHE is over there could be around 30,000 people who no longer qualify for Medicaid but have been kept on the program through the pandemic.

The state has published guidance on their website informing recipients on how to renew coverage, make changes to their snap benefit and sign up for text message notifications.