Medicaid is a critical insurance program for a substantial portion of the rare disease community. Typically, someone who is covered by Medicaid is required to “renew” or “recertify” their eligibility once every year, however, in 2020, Congress passed the Families First Coronavirus Response Act (FFCRA) allowing Medicaid programs to keep people continuously enrolled in Medicaid through the end of the COVID-19 public health emergency (PHE). FFCRA meant millions of Americans were able to maintain stable insurance coverage throughout the pandemic, but in late 2022, Congress removed the continuous coverage requirement, “delinking” it with the formal public health emergency period.
As of April 1st, 2023, states can resume normal operations. This means each state’s Medicaid office can now begin a formal redetermination process and disenroll individuals who no longer qualify for Medicaid and the Children’s Health Insurance Program (CHIP). States will have up to 12 months to return to normal eligibility and enrollment operations.
Millions of Americans will no longer qualify for Medicaid and will need to find alternative health insurance, such as those offered on the health insurance marketplace. The good news is that many of those who lose their Medicaid coverage will qualify for substantial subsidies to help them purchase a plan from the marketplace.
What Should Current Medicaid Enrollees Do?
Patients with Medicaid are encouraged to contact their Medicaid office to determine their eligibility status and confirm their contact information is up to date, so they receive all communications about their Medicaid benefits and eligibility. Patient organizations should remind Medicaid patients to speak with their Medicaid office.
If you have any questions about the Medicaid unwinding process in your state or how it may impact you and other patients, resources can be found below. Do you know of any additional resources available? Please share them with us!
- April 20th, 2023: Monthly Rare Disease Legislative Advocates (RDLA) Webinar – https://www.youtube.com/watch?v=xtKabiD_oCI
- Renew Your Medicaid or CHIP Coverage – https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/renew-your-medicaid-or-chip-coverage/index.html
- 50-State Unwinding Tracker – https://ccf.georgetown.edu/2023/04/01/state-unwinding-tracker/
- National Health Council (NHC) Medicaid Unwinding Resources – https://nationalhealthcouncil.org/issue/medicaid-unwinding-resources/
- Medicaid Enrollment and Unwinding Tracker – https://bit.ly/42omMpq
