For greater than a year-and-a-half, the continual enrollment requirement tied to enhanced Medicaid funding in the course of the COVID-19 pandemic has all however halted enrollment “churn,” the short-term lack of protection during which folks disenroll from Medicaid after which re-enroll inside a brief time frame.
Such disenrollments are anticipated to renew as soon as the requirement ends and states start processing Medicaid eligibility redeterminations. People might lose protection if they’re now not eligible or face limitations in the course of the redetermination course of, comparable to offering required documentation.
A brand new KFF evaluation that examined churn charges earlier than the pandemic finds that about 10 p.c of full-benefit Medicaid enrollees skilled a niche in protection of lower than a 12 months. Charges, which assorted by state, have been larger for youngsters and adults in comparison with the aged and other people with disabilities. Federal guidelines and state coverage selections on resuming disenrollments will affect churn charges following the tip of the continual enrollment requirement.
All of that is vital context for the controversy over the Construct Again Higher Act (BBBA) in Congress. The Home-passed model of the invoice consists of provisions to part out the continual enrollment requirement for Medicaid, with guidelines that might restrict how aggressively states might disenroll folks. For instance, states might solely disenroll people who’ve been enrolled a minimum of 12 consecutive months and should restrict eligibility redeterminations to not more than one-twelfth of all enrollees monthly via September 2022. States couldn’t disenroll people based mostly on returned mail except there have been a minimum of two failed makes an attempt to contact the person by a minimum of two totally different strategies (e.g., mail and textual content messages).
The BBBA additionally would require states to increase 12-month steady protection for youngsters in Medicaid and CHIP (presently an possibility for states) and would require 12-month steady protection for postpartum people, a change from the present requirement of 60-day postpartum protection and a brief possibility offered to states via the American Rescue Plan Act (ARPA).
For the complete evaluation about historic charges of Medicaid enrollment churn and a abstract of BBBA provisions that might restrict a return to churn, go to kff.org.