Blog
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It Looks Like Florida is Cutting Children Off CHIP in Violation of Federal Rules
While children are losing Medicaid coverage nationwide due to the unwinding process, new data reveals that Florida has disenrolled 22,576 children from its Healthy Kids CHIP program since January 1, 2024, when new federal protections requiring states to provide 12 months of continuous coverage in Medicaid and CHIP went into effect, which included barring states…
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State Momentum on Medicaid Doula Coverage, Rate Increases
Doula care continues to be a hot topic as our nation struggles to address the current maternal and infant health crises. Research has shown that doulas help reduce the risk of adverse birth outcomes, reduce infant mortality rates and help improve perinatal mental health. Access to doula care services can be out of reach for…
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Wondering what’s in the recent Medicaid and CHIP eligibility and enrollment rule?
On April 2, 2024, the Centers for Medicare & Medicaid Services (CMS) published the second part of a two-part final rule that simplifies the eligibility and enrollment processes for Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). The rule eliminates certain access barriers for children enrolled in CHIP; makes transitions…
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Federal Inspector General Highlights Medicaid Managed Care Mental Health Parity Failings
Last week, the Office of Inspector General (OIG) released a report finding that the Centers for Medicare & Medicaid Services (CMS) did not ensure that selected states complied with Medicaid managed care mental health parity requirements. Of the eight states reviewed — Arizona, Illinois, Kansas, Mississippi, New Jersey, New York, South Carolina and Texas —…
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Newly Updated Child Health Quality Data Now Available on State Data Hub
By Aubrianna Osorio and Emma Ford, CCF Graduate Research Intern Wondering how many children with Medicaid/CHIP coverage are getting their recommended well-care visits or developmental screenings? What about follow-ups for new medications, or dental sealants? Curious about how many women had a low-risk Cesarean section delivery or a prenatal or postpartum visit? Then check out…
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Marketplace Enrollment Among Those Losing Medicaid Coverage During Unwinding Increased by Nearly One-Third in the Second Month of Open Enrollment
As readers of Say Ahhh! know, I have been tracking monthly data (here, here, here, here, here, here, here and here) from the Centers for Medicare and Medicaid Services (CMS) on the number of people who were either previously enrolled in Medicaid or had experienced a denial or termination during unwinding who then selected a…
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CMS Released Additional Resources to Help Medicaid and CHIP Enrollees Retain Coverage
March 31 marks the one-year anniversary of the end of the COVID-related Medicaid continuous enrollment requirement. While it was expected that renewing nearly 90 million Medicaid enrollees would be a heavy lift for states, it’s taking some states longer to complete renewals due to system changes and efforts to improve ex parte renewal rates or…
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New ASPE Report: 17 Million Children Live in States That Could Benefit from 12 Months Continuous Coverage in Medicaid and CHIP
One commonsense policy change can make a huge difference in the lives of children. A new federal report released yesterday finds that the 12-month continuous eligibility period for children in Medicaid and CHIP that took effect on January 1, 2024 will protect more than 17 million children who live in states that previously did not…
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Biden Administration Adds Protections to Keep Children Covered in CHIP
Today the Biden Administration announced the final federal regulation “Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes” which, among other things, eliminates outdated red tape barriers to coverage for children insured through the Children’s Health Insurance Program (CHIP) that have been in place since its…
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Call Center Data Shows Trends Across States, But May Not Provide Full Picture
Before the unwinding began, Tricia Brooks highlighted why call center data would be an important piece of the puzzle in understanding how states’ returns to routine operations were going. Reporting call center data, along with other data reporting requirements enacted by the Consolidated Appropriations Act, 2023 (CAA) help CMS track how the unwinding is going…
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Update: Georgia Now Suing CMS For Denying an Extension Request That Hasn’t Really Even Been Filed
As we have recently covered, and as we explained before it launched, Georgia’s “Pathways to Coverage” demonstration is riddled with defects. Pathways is the state’s alternative to a standard Medicaid expansion—an expansion with work requirements that has resulted in Georgia enrolling (as best we can tell) less than one percent of those eligible (yes, that’s…
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Child Enrollment in the Marketplaces Rose by Nearly 40 Percent During 2024 Open Enrollment but Increase Offsets Only Modest Share of Child Medicaid Unwinding Enrollment Losses
On March 22, 2024, the Centers for Consumer Information and Insurance Oversight (CCIIO) at the Centers for Medicare and Medicaid Services (CMS) released more detailed information on the nearly 21.5 million people — a historic high by far — who enrolled in the Affordable Care Act’s marketplaces during the 2024 Open Enrollment Period. According to…
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A Deeper Dive into Florida’s Lawsuit Seeking to Undermine the New Requirement for 12-Months Continuous Eligibility for Children in Separate State CHIP Programs
As my colleague Joan Alker explains, the state of Florida recently sued the federal government to block guidance from the Centers for Medicare and Medicaid Services (CMS) implementing the new requirement that all states provide 12-months continuous eligibility for children in Medicaid and the Children’s Health Insurance Program (CHIP) as of January 1, 2024. Specifically,…
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Medicaid Managed Care Appeals and Grievances: GAO Takes a Look
Last week, GAO issued a performance audit of data on Medicaid MCO appeals and grievances. The database GAO examined was the first year of Managed Care Program Annual Reports (MCPARs) submitted by state Medicaid agencies to CMS. MCPARs are one of three reports on which CMS relies to conduct oversight of state managed care programs…
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Latest House Republican Study Committee Budget Plan Again Includes Draconian Medicaid Cuts
On March 20, 2024, the Republican Study Committee (RSC), whose members comprise more than three-quarters of the House Republican caucus, announced its fiscal year 2025 budget plan. The budget plan proposes to cut total federal Medicaid, Children’s Health Insurance Program (CHIP) and Affordable Care Act marketplace subsidy spending by nearly 54 percent over the next…
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CMS Informational Bulletin Calls Out 10 “Do Nots” in Conducting Renewals
In an Informational Bulletin (CIB) released on March 15, 2024, CMS reminds states of their obligation to comply with all existing federal renewal requirements in Medicaid and CHIP. The CIB is the result of questions CMS has received from states, stakeholders, and external partners regarding the permissibility of certain renewal practices. The CIB describes 10…
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Medicaid Managed Care: Congress Falls Short on Medical Loss Ratios
On March 9, the President signed into law the Consolidated Appropriations Act, 2024 (P.L. 118-122). Buried in the 428-page text is a 3-line provision delightfully, if somewhat obscurely, titled “Promoting Value in Medicaid Managed Care.” This is a classic in the genre of offsets, flying well under the radar to carry out its mission of…
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Medicaid and CHIP Provisions in Biden Administration’s Fiscal Year 2025 Budget
On March 11, the Biden Administration issued its budget plan for fiscal year 2025. Based on budget documents from the Office of Management and Budget (OMB) and the Department of Health and Human Services (HHS), here’s a brief summary of the budget’s major provisions related to Medicaid and the Children’s Health Insurance Program (CHIP), along…
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New from CCF: State Shares of Medicaid/CHIP MAGI Applications Exceeding 45-Day Processing Standard
Federal regulations establish a 45-day standard for acting on Medicaid applications for low-income children, families, and adults (also known as MAGI groups). Applications for MAGI groups are considered untimely and out of compliance with federal rules if processed after the 45-day standard. Just this week, CCF posted new maps that show month-by-month data reflecting the…
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Surveys Show Unwinding Awareness Lags, Highlighting Need for Outreach
If you know Medicaid, you know that everything is not fine right now. The unwinding of the pandemic continuous coverage provision continues to have major effects on enrollment, with the net decline in child enrollment now exceeding 4 million. Administrative data from across the country show that 73.2% of people who are losing coverage are…
