Medicaid Unwinding

By now everyone is probably wondering, will Medicaid ever unwind? Since early 2020, when the Public Health Emergency (PHE) was declared and the Families First Coronavirus Response Act (FFCRA) required states to provide continuous coverage for Medicaid enrollees until the end of the month in which the PHE ends, it allowed states to receive enhanced federal funding. This funding has allowed Medicaid and CHIP enrollment to grow to nearly 85 Million individuals.  

The current end date of the PHE is 10/15/22. However, HHS Secretary Xavier Becerra stated he would give states and providers 60-day notice before ending the PHE. No notice has been received, meaning another 90-day extension is expected, putting us into January 2023.  

Once Medicaid does begin to unwind, we will be facing the second largest change in healthcare, behind the roll out of the Affordable Care Act. CMS has been putting out guidance to states to prepare for unwinding and how to manage the volume of enrollees that need to be reviewed for continuing coverage or terminated and sent to the federally assisted marketplace for possible coverage.  Below are some steps and actions states are taking: 

  • Using other state agencies to verify information, IE household and income to determine eligibility and auto enroll those enrollees to prevent gaps, this is less than 25% of current enrollees. 
  • States and providers are partnering with community agencies and businesses to help enrollees update their information within their states Medicaid agency now before the PHE ends.  

The process to get back to the normal operations will take roughly a year. RCA has been helping the self-pay population qualify for the benefits they are entitled to since 1994. Please give us a call at 281.334.1855 to discuss how our organization can help you respond to this unforeseen challenge.  

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