A4 - Unwinding the Public Health Emergency: Opportunities for Title V programs to protect coverage for children and families during the Medicaid redetermination process

In March 2020, a federal Public Health Emergency (PHE) was declared by the U.S. Department of Health and Human Services to respond to the COVID-19 pandemic. Shortly after, the Families First Coronavirus Response Act (FFCRA) was signed into law to facilitate the nation’s response to the PHE and provide relief to states as they grappled with the pandemic. One important provision in FFCRA for states was a 6.2 percent increase in federal matching funds if their Medicaid programs meet specific Maintenance of Effort requirements, including continuous enrollment of all Medicaid beneficiaries through the end of the PHE. As a result, Medicaid enrollment since the pandemic has grown significantly. The most recently available data indicate that Medicaid enrollment grew by 26.3% (18.7 million enrollees) from February 2020 to July 2022. With the PHE forecasted to expire in 2023, all Medicaid enrollees, including 27 million children, must be redetermined for eligibility.

Advocates are concerned that enrollees who remain eligible for Medicaid may lose coverage due to backlogs, clerical errors, and other administrative-related issues such as outdated contact information. The redetermination process is a significant healthcare coverage challenge and could trigger a Medicaid coverage crisis for eligible enrolled populations including women, children, and families. The unwinding of the PHE will place a significant burden on understaffed state Medicaid agencies to redetermine enrolled individuals. As trusted messengers with deep ties in the community, state and local MCH professionals and advocates have an important role in supporting families through this uncertain time and ensuring that MCH populations have continuity of coverage as they are redetermined.

This session will explore the current landscape of the Medicaid redetermination process and provide analysis of challenges that states are facing as the unwinding progresses. AMCHP will present strategies that MCH programs and state and community advocates are utilizing to maintain coverage for MCH populations. The session will also feature a speaker from the Centers for Medicare and Medicaid Services (CMS) to discuss the opportunities and flexibility within existing Medicaid law that can be leveraged to maintain coverage gains for MCH populations. The session will close with an interactive discussion in which participants will have an opportunity to share their states’ progress in the unwinding and discuss strategies as a group. This session directly relates to the conference theme as the unwinding has brought to light the importance of working with leaders at all levels, especially in hard-to-reach communities. This session is important to provide timely updates and analysis of the Medicaid redetermination process and implications for MCH populations.