HHS wants states with the highest rates of children dropped from Medicaid to use certain federal rules that make it easier to get families back on coverage.
In letters sent Monday to the governors of Arkansas, Florida, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota and Texas, HHS Secretary Xavier Becerra urged the states to take up more of the 400 options CMS has offered to ensure coverage. The options include allowing states to use enrollee information they have to auto-renew coverage.
HHS also issued new guidance for states Monday, including an option to give kids an additional 12 months to get on the rolls. That option is available through 2024, CMS Administrator Chiquita Brooks-LaSure told reporters.
Becerra also asked the states to remove barriers to Children’s Health Insurance Program enrollment for children no longer eligible for Medicaid, reduce call center times for families and expand their Medicaid programs if they haven’t already.
“Because all children deserve to have access to comprehensive health coverage, I urge you to ensure that no child in your state who still meets eligibility criteria for Medicaid or CHIP loses their health coverage due to ‘red tape’ or other avoidable reasons as all states ‘unwind’ from the Medicaid continuous enrollment provision that was in place during much of the COVID-19 public health emergency,” Becerra wrote.
According to HHS, the nine states are responsible for 60 percent of children’s coverage losses between March and September.
“State choices matter,” CMS Deputy Administrator Daniel Tsai said Monday. “States that have taken up the historic number of new policy flexibilities that CMS has put on the table are better able to protect kids' coverage.”
The data: According to new HHS data, the 10 states that haven’t expanded Medicaid — Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming — disenrolled more children than states that have expanded Medicaid combined. That's partly because expansion states have taken up more CMS flexibilities than non-expansion states.
In non-expansion states, youth who turned 19 during the Covid-19 public health emergency account for, on average, 27.6 percent of disenrollments among children in these states compared with 12.1 percent of disenrollments in expansion states.
Requests for comment from the nine states cited by HHS were not immediately returned.
How we got here: After the end of the public health emergency in May, states were required to review the eligibility of Medicaid enrollees. The subsequent unwinding saw nearly 3 million children, to date, kicked off coverage, according to the Georgetown University Center for Children and Families. In August, HHS sent letters to all states, warning that they might be running afoul of federal requirements, pointing to long waits at call centers, high number of disenrollments due to paperwork problems and a slow application process.
In September, CMS said half a million people, including kids, who lost coverage mistakenly lost it due to errors by the states. Those states were told to pause disenrollments and reinstate individuals who lost coverage or risk losing federal funding.
