The Biden administration wrote to companies on Thursday requesting they keep their employees insured as millions transition to Medicaid coverage.
During the COVID-19 pandemic, Medicaid coverage terminations were paused until March 31, 2023. Now, state Medicaid agencies are returning to regular operations, renewing coverage for eligible individuals and terminating it for those who no longer qualify.
Due to this transition, around 3.8 million individuals are projected to lose Medicaid eligibility and may need to seek alternative coverage, with employment-based coverage being a potential option.
Chiquita Brooks-LaSure, the administrator of the Centers for Medicare and Medicaid Services (CMS), sent a letter to employers on Thursday stating that individuals who have lost Medicaid coverage should have the opportunity to enroll in group health plans at any point in the next year through a special enrollment period.
Medicaid is a health insurance program designed to provide coverage for lower-income individuals. While the program receives significant financial support from the federal government, it is primarily administered by individual states.
Companies are required to provide their employees with a minimum of 60 days to enroll in their group health plans. However, Ms. Brooks-LaSure said that this timeframe is insufficient considering the significant number of individuals who have recently lost Medicaid coverage.
“Given the exceptional circumstances surrounding the resumption of Medicaid and CHIP renewals for the first time in three years, many individuals will need more than the typical 60-day window after loss of Medicaid or CHIP coverage to apply for and enroll in other coverage,” she wrote.
Medicaid coverage surged to a historic high of more than 93 million people by March 2023, with Congress barring states from disenrolling people during the pandemic starting in March 2020.
Over the next 12 months, as states phase out the continuous enrollment provision, they will reassess the eligibility of all Medicaid enrollees. Those who are no longer eligible or are unable to complete the renewal process may be disenrolled.
It is anticipated that millions of people will lose their Medicaid coverage during this period of unwinding the continuous enrollment condition.
Ms. Brooks-LaSure mentioned that many individuals might have missed notices from state agencies regarding the termination of their Medicaid coverage. As a result, “employees may not realize that they lost their Medicaid or CHIP coverage until they access care,” she said, adding that they might then miss their opportunity to enroll in other coverage.
The Health and Human Services Department estimates that out of the people expected to lose Medicaid coverage, approximately 3.8 million individuals are eligible for insurance through their employer, while another 2.7 million are eligible for subsidized insurance through the Affordable Care Act marketplaces.
To assist those affected, CMS has established a special enrollment period, running until July 2024, allowing people to enroll in subsidized coverage through the Affordable Care Act insurance marketplaces.
Ms. Brooks-LaSure noted that this policy should help people as their coverage transitions over the next year.
