October 2021 Medicaid Changes

Health Exchange Open Enrollment

The open enrollment time frame is set for November 1st to January 15th.

COBRA

American Rescue Plan Act COBRA premium assistance flexibilities have ended, which means that the federal government is no longer paying 100% of premiums.

Medicaid State of the Union

California

The state passed AB 133 which allows residents who are 50 and older that are income-eligible to receive Medicaid, no matter their immigration status. The state estimates there will be 235,000 newly eligible recipients.

The governor also signed the SB 65 bill, otherwise known as the California Momnibus Act. The new law is designed to improve maternal and infant outcomes, with an intentional focus to help minorities. It provides a deeper level of research on pregnancy-related deaths, includes Medi-Cal coverage for doulas and it extends postpartum coverage.

Georgia

Georgia’s limited expansion is delayed by CMS due to work requirements. The plan was to pause the implementation of this partial expansion, but CMS is pushing back and we might not see a final decision until 2022, or it may be rescinded.

The partial expansion may not have covered a large percentage of new enrollees, and it did not include retro-active Medicaid for the new population. U.S. Senator Raphael Warnock and other congressional leaders are supporting full Medicaid expansion within the state.

Idaho

HB 316 passed by the House, and it states that anyone who is eligible to apply for Medicaid or to purchase private health insurance will be ineligible for county indigent or catastrophic healthcare programs.  The law has already taken effect, but it will not be fully implemented until 2023.

Kentucky

Beginning in 2022 the state will revert back to Kynect and become a state-based health exchange on the insurance marketplace.

Missouri

Missouri voters approved Medicaid expansion, but it was not funded through the legislative sessions. After legal battles, the Missouri Supreme Court ruled expansion as constitutional and ordered that the application process begin.

The state was ordered to begin accepting applications in August but was not able to process or approve those applications until October. More than 17,000 individuals have applied, and an estimated 275,000 Missouri residents could be eligible.

New Hampshire

New Hampshire is planning for the redetermination of their Medicaid population, but 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 and make changes to their snap benefits. Additionally, they are urging residents to sign up for text message notifications.

Oklahoma

Oklahoma expanded as of July 1st and nearly 170,000 Oklahomans have qualified since then. 

The state has an 1115 waiver that was supposed to be effective July 1st, but it has not been approved by CMS. One of the biggest impacts of that approval is not allowing retro Medicaid for the expanded population. So far, it is unclear if the current CMS administration will support the request.

Additionally, the state is looking to shift 742,000 individuals from fee-for-service Medicaid to Managed Medicaid later this month.

Texas

The Texas Health and Human Services Commission (HHSC) released a request for proposals for the procurement of Texas STAR Health, the state’s Medicaid managed care program for children and young adults in foster care. Responses are due by December 6th, with awards anticipated for June 2022. HHSC will award one, six-year contract beginning August 2022, with up to three, two-year renewals. Historically, the contract has been worth $361 million annually. Implementation is expected September 2023.

Virginia

Income-eligible pregnant women are now able to obtain Medicaid coverage regardless of their immigration status, and all pregnant women will now have postpartum coverage for 12 months.

Also, the state has created a temporary policy change for Afghan evacuees. Adult evacuees who enter the U.S. with humanitarian parole status no longer have to meet the 5-year residency requirement to be eligible for Medicaid.