November 2020 Medicaid Changes

Parallon’s eligibility and advocacy team continues to monitor the state of Medicaid eligibility as impacted by COVID-19.In addition, open enrollment for the health insurance exchanges began November 1st and ends December 15th. A few states running state facilitated health exchange programs have extended open enrollment into January. CMS recently approved 2 waivers in Georgia. The 1115 waiver will implement limited Medicaid expansion with a few caveats and the 1332 waiver will remove the state completely from the health exchange platform. Both changes are expected to implement July 2021 but could be halted or delayed by the Supreme Court.

Below we breakdown the latest Medicaid changes for November 2020,

Here is the November 2020 Medicaid State of the Union:

Alaska Medicaid Updates

Many of the flexibilities due to COVID-19 are with food stamp benefits but there are changes that have been put into place with Medicaid. The most notable is, anyone currently on Medicaid will stay active without having to renew until next year

California Medicaid Updates

Covered California, open enrollment began November 1st and has extended the time frame to sign up until January 31, 2021.  In addition to the anticipated increase we are beginning to see coalition of groups forming to assist consumers with health insurance selection. Molina Healthcare of California and Inland Empire Health Plan are collaborating on an initiative called "Together4IE" which is directed to assist with Medi-Cal and insurance marketplace plans.

Colorado Medicaid Updates

Governor Polis submitted a 35 billion dollar plan for the state budget. The proposal will support state employees’ pension funds, Medicaid and human service caseloads. Budget sessions begin January 2021 and go into effect July 2021. Since Colorado is a state facilitated health exchange they have also chosen to extend open enrollment until January 15th.

Florida Medicaid Updates

COVID-19 is creating an unprecedented amount of people losing jobs and the uninsured rate is seeing its highest percentages in years. Since May, the Florida uninsured rate rose to 25% making it the second highest of all 50 states, including District of Columbia. Forbes magazine, explains the challenges Florida hospitals face in transitioning patients to nursing facilities, affordability and access, and support for family caregivers.

Georgia Medicaid Updates

In October, CMS approved the 1115 waiver titled Georgia Pathways and the 1332 waiver called Georgia Access. The 1115 waiver partially expands coverage to childless adults along with qualifying activity requirements such as employment, education, or volunteering. This waiver is set to go live July 1, 2021. The 1332 waiver replaces the health exchange platform but allows residents to purchase health insurance with a state facilitated insurance program that is not affiliated with the ACA plans. Considering the controversial nature of these waivers it is possible the decision will go to the Supreme Court.

Idaho Medicaid Updates

Like many states, Idaho is seeing an increase in Medicaid enrollment and as the 2021 budget season quickly approaches they are looking at ways to control cost. Some of the discussion for cost reduction are around provider rate cuts, higher tax assessments on nursing homes, and benefit reductions.

Indiana Medicaid Updates

The Healthy Indiana Plan (HIP) waiver renewed in February 2018 and was set to expire December 2020. Not only did CMS approve the renewal but it is not set to expire for 10 years which is the longest wavier approval of any state. Typically waivers are 3-5 years. The HIP waiver continues contributions into a POWER account, expands the gateway to work program, and adds a tobacco use surcharge that increases users' POWER account contributions by 50% beginning in their second year of enrollment.              

Kansas Medicaid Updates

The state decided to part ways with the 3rd party contractor Maximus who assisted the state with processing Medicaid applications among other duties. Beginning 2021, the duties will not be handled in-house as the state has hired the New Jersey based company Conduent.

Kentucky Medicaid Updates

Governor Andy Beshear notified CMS that Kentucky plans to transition back to the Kynect system, with a fully state-run exchange by the fall of 2021. For the 2021 enrollment period beginning 11/1/2020 the state will be going through the platform until the following year.

Louisiana Medicaid Updates

Open enrollment for Louisiana Medicaid managed care members began October 15, 2020, and runs through November 30, 2020. Medicaid members will have a choice between two dental and five health plans to be effective on January 1, 2021. Louisiana Department of Health announced that several new leadership positions have been filled, including the Medicaid Executive Director and Deputy Director of Eligibility. All positions are effective October 1, 2020.

Mississippi Medicaid Updates

A push for Medicaid expansion is happening in several southern states but there appears to be an extra push in Mississippi. We're beginning to see a push from advocacy groups such as Mississippi Health Advocacy Program, the Mississippi Center for Justice, and Southerners for Medicaid expansion.

Missouri Medicaid Updates

Medicaid enrollment numbers have jumped nearly 100,000 people since COVID-19. Medicaid expansion will begin in July 2021 and it's predicted Medicaid enrollment will increase to about 230,000 people. With budget concerns Medicaid expansion will face many barriers before fully implementing in the state.

Nevada Medicaid Updates

Effective October 1st 2020, the company who owns DXC Technology has been purchased by Gainwell Technologies. DXC was the company who processed claims for the state. The state does not expect a huge impact with the change but a memo was sent out to organizations communicating the change. Nevada is also has a state facilitated health exchange that has extended their open enrollment time frame to January 31, 2021.

North Carolina Medicaid Updates

Legislators approved a Medicaid package that increases next year’s funding by over $460M and directs the program begin its long-delayed shift from traditional payments to managed care by July 2021. The federal Declaration of Emergency that was scheduled to end July 25, 2020, now appears to be ongoing. Department of Health and Human Services (NCDHHS) announced in October 1, 2020, a new $7M partnership with United Providers of Health (UPOH), which is a network of independent community-based providers to address unmet health needs of historically marginalized communities. Governor Roy Cooper, who has been a consistent supporter of Medicaid expansion, was re-elected back into office but faces opposition in both the senate and the house, which will make Medicaid expansion a challenge to implement within the state.

Oklahoma Medicaid Updates

The state announced plans to transition about 21,000 of its Insure Oklahoma members to the Medicaid expansion program, effective July 1, 2021. Oklahoma took its first steps on October 16, 2020, seeking to privatize care to most Medicaid recipients.

South Carolina Medicaid Updates

The state planned to roll out a new MMIS system, but due to delays it will not be rolled out until 2021.

Tennessee Medicaid Updates

In November 2019, the state submitted a controversial 1115 waiver to CMS that would allow portions of Medicaid to be funded in a block grant. This would cap the amount of Medicaid spending but completely change the way Medicaid is funded today. This month CMS announced that the proposal is still under consideration and is a "high priority" but has been delayed due to COVID-19. A timeline for the review was not provided.

Texas Medicaid Updates

On October 28, 2020 state officials announced that some Medicaid and Children’s Health Insurance Program (CHIP) flexibilities put in place during the COVID-19 pandemic that were to expire on October 23rd have been extended through November 30, 2020. In addition, the state also provided a memo that in November all SNAP recipients will get the maximum amount for the household size to purchase food and the state is also continue flexibilities on Medicaid renewals.

Utah Medicaid Updates

A new COVID-19 uninsured test coverage is effective beginning June 1, 2020. The new program is designed for patients who do not qualify for regular Medicaid. The programs is retroactive beginning June 1, 2020, but does not cover in-patient stays. Patients must not be eligible for HPE, be a US citizen, Utah resident, and have no health insurance.

Virginia Medicaid Updates

Since January 2019, 452,000 people have gained coverage due to Medicaid expansion. More than 100,000 recipients enrolled since March due to COVID-19.

*This article was published November 30, 2020.