Some states surveyed by a congressional advisory group want an exact date when the COVID-19 public health emergency expires and with it a requirement to not drop anyone from Medicaid’s rolls.
The Medicaid and CHIP Payment and Access Commission (MACPAC) released a report during a meeting Wednesday based on surveys of five states who are preparing for the unwinding of the PHE, which now runs through October.
“The unwinding will likely be challenging for all states,” said Martha Heberlein, a staffer with MACPAC. “Many states say they are working with plans, providers and communities to update contact information.”
At the onset of the pandemic, states could get a boost to their federal matching rate for Medicaid funding in exchange for not dropping anyone off Medicaid for the duration of the PHE. When the PHE goes away, states have 14 months to redetermine the eligibility for all its Medicaid beneficiaries.
Department of Health and Human Services (HHS) Secretary Xavier Becerra extended the PHE until October and has promised to give stakeholders a 60-day notice that it will not be extended again.
The lingering uncertainty around when exactly the PHE will go away has weighed on some states. The National Association of Medicaid Directors has asked HHS for a 120-day heads-up, which Becerra has said is not feasible since the emergency can only be extended by 90 days.
The states told MacPAC that they have been preparing for the unwinding to start and say that 60 days would be sufficient. However, one of the states surveyed by MacPAC said that a set date for the end of the PHE would be helpful with “hiring temporary staff, but the sentiment wasn’t universally shared,” Heberlein said.
How the redetermination is handled could have a major impact on coverage. An estimate from the think tank Urban Institute finds that 15 million people could lose coverage after the emergency ends.
Other states have said that a concrete deadline will help create a more concrete operational timeline. The constant starts and stops are consuming state resources, and one official shared that continually notifying beneficiaries about the unwinding could “desensitize them to the situation,” Heberlein said.
“The repetitive hurry up and wait is wearing on everyone,” she added.