Public Health Emergency
On July 15th, HHS Secretary Xavier Becerra issued a declaration that the COVID-19 Public Health Emergency (PHE) would be renewed for an additional 90 days. In addition, the states are to receive a letter 60 days prior to the PHE ending which has not been received at this time.
Upon the conclusion of the PHE, states will need to develop plans to restore routine operations in their Medicaid, CHIP and BHP programs. States will have a significant volume of eligibility actions to complete once they begin the unwinding period, including pending applications, renewals and redeterminations necessitated by changes in beneficiary circumstances.
Changes to Health Exchange Premiums and Premium Tax Credits
The American Rescue Plan Act implemented large subsidies and more affordable plans for 2021 and 2022.
Congress will need to extend that coverage or it will sunset by the end of the year, leaving 14.5 million people at risk for increased premiums.
Medicaid State of the Union
Governor Jared Polis signed HB22-1289 to expand full-scope Medicaid to undocumented pregnant women and children. The program will be effective beginning in 2025. More recently on June 23, the Department of Health and Human Services (HHS) along with other departments approved the states 1332 waiver. The waiver is effective January 2023 and creates a Colorado Option that can be sold on and off the marketplace. All plans will be required to have standardized options that will reduce health disparities.
As of July 1st, the state provided several recent changes. Some of those changes include Legal Permanent Residents who have not met the 5 year limit are eligible for Emergency Medicaid (EM) and any EM approval will now show for 12 months from date of approval. Also, as with many states, postpartum Medicaid is expanded from 60 days to 12 months.
Although CMS opposes work requirements to be eligible for Medicaid, the state has developed a bill that would put Medicaid work requirements on the ballot for voters to decide in the November election. If approved, it would still need final approval by CMS via the 1115 waiver.
On June 6th, Kim Evans, the Director of the Family Services Division, told lawmakers that by the end of July, wait times for processing Medicaid applications would be down to 45 days.
The Virginia Department of Medical Assistance Services (DMAS) recently provided an important update regarding current and future delays. The Virginia Information Technologies Agency is in the process of moving the data center that is used for Common Help applications. Due to existing delays and the transition, application processing timelines may continue to increase for a few months. In addition, the state has migrated from an old MMIS system to a new system called MES.
Regarding the end of the Public Health Emergency, Virginia plans to use text messaging to connect with enrollees to assist with the end of the PHE, however they are required to get consent from the enrollees before the state can send text messages. To boost enrollees, the state plans to ask enrollees to opt out of receiving text messages, instead of asking them to opt in. The state is reviewing its legal options to make that happen. However, Medicaid MCOs are able to text around 316,000 enrollees.
Starting in July, postpartum Medicaid is extended to 12 months.