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  • Deadlines for laid-off workers to get health care coverage coming next week

    News Article

    CBS News The first deadlines to qualify for fallback coverage under the Affordable Care Act are looming for many laid-off workers who lost their health insurance in the coronavirus shutdown… The federal-state Children’s Health Insurance Program and Medicaid cover kids in families with incomes well above the poverty level. “Medicaid is open year round if…

  • Increased CHIP Matching Rates under House-Passed HEROES Act

    Edwin Park

    The House-passed HEROES Act (H.R. 6800) would provide an additional one-year increase to the federal Medicaid matching rate (from July 1, 2020 through June 30, 2021), on top of the FMAP increase enacted as part of the Families First Act (P.L. 116-127).  As I have explained, the further FMAP increase, in turn, would increase the…

  • House HEROES Act Would Also Further Raise CHIP Matching Rate

    Edwin Park

    The temporary 6.2 percentage point increase in the federal Medicaid matching rate enacted as part of the Families First COVID-19 legislation (P.L. 116-127) benefited the Children’s Health Insurance Program (CHIP) as well.  Because the formula used to calculate each state’s CHIP matching rate is based on the regular FMAP, the Families First FMAP increase resulted…

  • HEROES Act Includes Other Provisions Strengthening Medicaid and CHIP

    Edwin Park

    The HEROES Act bill (H.R. 6800), which the House will likely consider Friday, May 13, would provide a critically needed, additional one-year increase in the federal Medicaid matching rate (FMAP) and block the Trump Administration from finalizing the damaging Medicaid Financial Accountability Rule (MFAR) during the duration of the public health emergency.  It also includes…

  • House HEROES Act Bill Would Provide Significant Further Support for State Medicaid Programs

    Edwin Park

    As I have previously written, while helpful, the temporary 6.2 percentage point increase in the federal Medicaid matching rate (FMAP) provided by the Families First COVID-19 response legislation (P.L. 116-127) is clearly insufficient to address the sharply higher state Medicaid costs and overall budget deficits states will experience in this health and economic crisis.  That…

  • Waive, Suspend, Delay, Eliminate, Forgive CHIP Premiums? Semantics Matter for Families who Need Fiscal Relief from COVID-19 Impacts

    Tricia Brooks

    As families lose their jobs and employer-sponsored health insurance, eliminating Children’s Health Insurance Program (CHIP) premiums is a great way to provide continuity of coverage for children and fiscal relief for families. But there may be a catch. While some states are submitting state plan amendments to waive collection of premiums or temporarily halt disenrollments…

  • Critical Need for Further, Large FMAP Increases to Sustain State Medicaid Programs During Economic Crisis

    Edwin Park

    As part of the Families First COVID-19 legislation, Congress provided a temporary 6.2 percentage point increase in the federal Medicaid matching rate (FMAP) for the duration of the public health emergency.  The bipartisan National Governors Association and the National Association of Medicaid Directors are both urging Congress to provide further FMAP increases (totaling at least…

  • Governors and Medicaid Directors Continue to Press for Withdrawal of Damaging Medicaid Fiscal Accountability Rule

    Edwin Park

    As I have previously written, a significant share of the inadequate fiscal relief that Congress has already provided to states facing huge budget shortfalls could be canceled out if the Trump Administration goes ahead and finalizes its highly damaging “Medicaid Fiscal Accountability” rule (known as MFAR).  The rule would adversely affect how states finance their…

  • Bipartisan Group of Medicaid Directors, AMA, MACPAC and Stakeholders Issue Urgent Pleas for More Medicaid Help for Safety Net Providers

    Joan Alker

    Those of us who have worked on Medicaid for years have a running joke about Medicaid being the missing “M” in the acronym CMS – which stands for the federal Center for Medicare & Medicaid Services. Medicare has always been the big dog on the block – both in terms of political clout, size and…

  • The Paycheck Protection Program and Healthcare Enhancement Act Fails to Fund the Nation’s Frontline Health Insurer

    Andy Schneider

    Today, the Paycheck Protection Program and Health Care Enhancement Act became law.This is the fourth piece of legislation addressing the COVID-19 pandemic and the nation’s economic downturn.  It provides additional funding for programs created by the CARES Act, (P.L. 116- 123), including  another $380 billion to support small businesses and another $75 billion to help…

  • CMS Releases Telehealth Toolkit with Special Emphasis on Pediatrics

    Tricia Brooks

    The COVID-19 pandemic has significantly disrupted access to health care as providers scramble to up their game in regard to telehealth. To assist states and stakeholders in advancing the use of telehealth, CMS has released a Medicaid and CHIP Telehealth Toolkit with a special emphasis on pediatrics. The toolkit is intended to help identify state-level…

  • COVID-19 Medicaid Waiver Soup Explained

    Andy Schneider

    Over the past month there has been an explosion of Medicaid waiver activity relating to the COVID-19 pandemic.  This activity is not to be confused with the implosion of the Medicaid section 1115 work requirements waivers, which would undermine coverage.  Instead, the COVID-related waivers are designed to help state Medicaid programs respond to the pandemic,…

  • Getting MAGI Right: Do COVID-19 Stimulus Payments and Extra Unemployment Count toward Medicaid Eligibility?

    Tricia Brooks

    The most popular blogs I’ve ever written were part of a 2015 series about Getting MAGI right. At the time, MAGI was a little understood acronym for Modified Adjusted Gross Income, which changed the way income and household size is counted for Medicaid and CHIP eligibility for children, pregnant women, parents and expansion adults. As…

  • Uninsured and Unemployed? Medicaid and CHIP Provide Lifelines to Families in Need

    Cathy Hope

    In these tough times, when so many people have lost their jobs and and their health insurance, Medicaid and the Children’s Health Insurance Program (CHIP) are lifelines families can turn to for help covering the cost of health care.  Medicaid and CHIP provide free or low-cost health coverage for children and pregnant women with low…

  • Now is the Time to Remove CHIP Waiting Periods and Welcome Kids into Coverage

    Tricia Brooks

    While maintenance of effort (MOE) provisions in the Families First Coronavirus Response Act and long-standing MOE requirements for children prevent states from implementing any new eligibility or enrollment barriers, states should also be taking steps to remove existing barriers to coverage, including CHIP waiting periods. Before the Affordable Care Act’s (ACA) coverage expansions were implemented…

  • Approved Disaster Relief SPAs Reduce Burdens on Beneficiaries

    Allexa Gardner

    CMS has begun approving states’ disaster relief State Plan Amendments in response to the COVID-19 crisis. As my colleague Tricia Brooks recently described, these SPAs allow states to make temporary changes to eligibility, enrollment, and cost-sharing policies among others flexibilities. It is important to note that the changes requested, and subsequently approved, in the disaster…

  • Pandemic Induced Pragmatism: The State of Medicaid Waiver Policy

    Joan Alker

    Amongst other ways in which life has dramatically changed in the last month, Section 1115 Medicaid waiver terrain has experienced a tectonic shift. For those of us who have been responding to massive numbers of public comment periods over the past two-plus years, only one waiver opened for public comment that we are commenting on…

  • Medicaid and CHIP Eligibility Verification Flexibilities Help States Keep up with Increased Application Volume due to COVID-19

    Tricia Brooks

    As more and more Americans file unemployment claims, we can expect an increase in Medicaid applications. This increased demand comes at a time when Medicaid eligibility enterprises are challenged with transitioning eligibility workers to telework and may be experiencing workforce shortages due to worker illness or family caretaking responsibilities resulting from the COVID-19 pandemic. But…

  • Recent Medicaid Expansion Activity in Eight States during the COVID-19 Crisis

    Adam Searing

    As states respond to the COVID-19 crisis, those that have yet to expand Medicaid are facing rising calls to reverse their opposition and quickly provide affordable health care to millions of residents. The oncoming double hit to states of rising numbers of residents needing advanced, expensive health care coupled with truly staggering job losses –…

  • States Should Accept all Federal Funding Already on Table to Fill as Many Health Coverage Gaps as Possible While Pressing for More

    Kelly Whitener

    States are under tremendous pressure to continue to provide essential services even as resources dwindle, underscoring the importance of the 6.2 percentage point increase in the federal medical assistance percentage (FMAP) in the Families First Coronavirus Response legislation Congress passed last month. Unfortunately, the health and economic consequences of this pandemic necessitate an even bolder…