The Biden-Harris administration announced a new proposed rule Wednesday, which will simplify the process for people to enroll and renew coverage in Medicaid, the Children’s Health Insurance Program (CHIP) and the Essential Health Programs.
If finalized, the rule would limit renewals to once every 12 months, allow applicants 30 days to respond to requests for information and require consistent renewal processes across states, the Centers for Medicare & Medicaid Services said in a news release & Medicaid.
“This proposed rule will ensure that these individuals and families, often from underserved communities, have access to the health care and coverage to which they are entitled – a fundamental principle of health care equity,” said CMS Administrator Chiquita Brooks-LaSure.
The announcement comes as the end of the Covid-19 public health emergency, which is currently set for October, but could be extended for another 90 days, approaches. When the emergency period ends, so does the continuous enrollment requirement, which until now prohibited states from disenrolling Medicaid beneficiaries. In return, states receive a temporary increase in federal Medicaid matching rates. A recent HHS report designed that about 15 million people will lose coverage when the public health emergency ends.
Currently, the enrollment and renewal process is onerous and deters many Americans from enrolling even when they are eligible.
“We’re losing coverage because of a number of administrative processes,” Daniel Tsai, deputy administrator and director of the Center for Medicaid and CHIP Services, said on a call with reporters Wednesday.
One obstacle Tsai mentioned is ending a person’s eligibility for coverage because they can’t be reached by mail. The rule would create specific guidelines for states to review available data before withdrawing eligibility in this case.
“Many of the people we serve in Medicaid and CHIP move frequently and lose coverage … not because they’re ineligible, but because they didn’t get a piece of paper in the mail and they didn’t respond to that piece of paper,” he said.
Other proposed changes include, under a information sheet:
- Eliminating the requirement to apply for other benefits as a condition of Medicaid eligibility.
- Provide automatic enrollment of Supplemental Security Income recipients into the pool of qualified Medicare beneficiaries, with limited exceptions.
- Establish a clear process to prevent the termination of eligible beneficiaries who must switch between Medicaid and CHIP when their income changes or when they become eligible for the other program.
- Allowing CHIP beneficiaries to remain enrolled or re-enroll without a lock-in period for non-payment of premiums.
- Eliminate enrollment waiting periods and prohibit annual and/or lifetime limits on CHIP benefits.
- Removing references to outdated technology and requiring records to be stored electronically.
- Providing specific timelines for states to complete Medicaid and CHIP renewals.
There will be a 60-day comment period, after which the proposed rule will be reviewed by the US Department of Health and Human Services.
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