Expedited CMS Approvals in Washington and Oregon Can Further Minimize Coverage Disruptions, Aid Unwinding

New CMS approvals in Oregon and Washington will protect health coverage for more children and families during this year’s consequential unwinding, minimizing coverage disruptions and easing transitions to new sources of health coverage.

Oregon receives approval to ease coverage transitions for certain adults, allowing them to stay in Medicaid until they can transition to alternative coverageOn April 20, CMS approved Oregon’s “Bridge Plan Amendment” request. The approval authorizes the state to extend Medicaid eligibility to non-elderly adults with incomes between 138 and 200 percent FPL who were enrolled in Medicaid prior to being determined ineligible at redetermination following the end of the federal continuous enrollment protections. These individuals will remain covered through Medicaid until they successfully transition into the state’s planned Basic Health Plan (BHP) or other available state coverage options. CMS estimates approximately 55,000 individuals will maintain coverage through this amendment.

Washington the 2nd state to adopt continuous coverage from birth to kindergarten – On April 14, Washington joined Oregon and is the second state approved by CMS to implement continuous coverage in Medicaid for children from birth to kindergarten. (CMS is still reviewing Washington’s full waiver renewal application submitted last year, which offers additional promising approaches to advance health equity and improve access to needed care for children and families.)

These approvals are timely since Oregon and Washington have already begun the process of renewals, with Washington starting disenrollments in June. Once children under age 6 have their eligibility redetermined, they will effectively be placed at the end of the line for redeterminations until they reach kindergarten. Starting now, any young child whose eligibility is successfully redetermined for Medicaid will maintain coverage until the end of the month of their 6th birthday unless they move out of state or choose to disenroll – no additional paperwork for the family and no extra outreach and administrative work required by the state until that time.

Washington’s unwinding projections help to prove the logic of this new policy: State estimates show that children under age 6 are the least likely to be found ineligible for coverage after the federal coverage protections expire.

Momentum continues to build on multi-year continuous coverage for children as a school readiness and early childhood development strategy: New Mexico’s waiver request is pending at CMS, as California and Illinois work on their own applications (Illinois is seeking two-year cycles for all children). State lawmakers are also debating some version of continuous coverage for young children, with live bills in Rhode Island, Minnesota, and Ohio (0-3) just to name a few.  Perhaps one silver lining of the unwinding’s risks of coverage loss for eligible children is the renewed focus by state on the need to minimize coverage disruptions and focus on the youngest children during a time of rapid development.