Medicaid Continuous Coverage Extended with Renewal of the PHE

The Biden administration has extended the public health emergency (PHE) for 90 days, from October 18, 2021 through January 16, 2022. What does this mean for Medicaid?

First, the maintenance of effort provisions in the Families First Coronavirus Response Act remain in effect until January 31, 2022 (the end of the month after the PHE ends). States must maintain their Medicaid eligibility levels and enrollment procedures that were in effect as of January 1, 2020. States must keep individuals who were covered by Medicaid as of March 18, 2020, or who subsequently were enrolled, continuously covered until January 31, 2022.

It also means that states will continue to receive enhanced federal funding for Medicaid via a 6.2 percentage point bump in the state’s Federal Medical Assistance Percentage (FMAP) through the first quarter of 2022 (March 31). CHIP expenditures also receive an enhanced federal match of 4.34 percentage points.

The Biden administration has promised to give states a heads up at least 60 days in advance of the end of the PHE. Some Medicaid stakeholders have taken the administration’s projection that the PHE would be in place for the entirety of 2021 to mean that it would end December 31, 2021. But since PHEs are declared in 90-day increments, the administration would need to take specific action to terminate the PHE early and give states advance notice by November 1, 2021 if it intends to end the PHE at the end of 2021.

I personally think that’s unlikely to happen, given that not all children are yet eligible for COVID vaccines and the U.S. continues to experience 83,000 new cases and over 1,500 deaths a day based on current 7-day averages. It remains to be seen whether our country will be in a better place come mid-January when a decision to extend the PHE again will need to be made. States will have a heavy lift in catching up on delayed renewals and changes in circumstances and resuming normal eligibility and enrollment operations. While it’s helpful that the Biden administration plans to give states at least a 60-day advance notice, even more notice for states to prepare would be welcomed.