Unwinding the Medicaid Continuous Coverage Requirement - Frequently Asked Questions

The end of this pause is leading to an extraordinary workload for states to determine eligibility and renew coverage for the millions of people enrolled in the program. [...] What standards did the 2022 legislation include to mitigate coverage losses? In addition to setting a date certain, the enacted legislation gives states additional financial support during the unwinding period.5 While the enhanced Federal Medicaid Assistance Percentage (FMAP) under FFCRA included a full sunset of the enhanced funding at the end of the quarter in which the PHE ends, the year-end le. [...] The year-end legislation also lays out clear procedures for CMS to enforce the policies that states are required to follow as they unwind.6 States must submit, and the Department of Health and Human Services (HHS) must make publicly available, monthly reports of key unwinding metrics such as number of renewals completed ex parte, coverage terminations due to procedural reasons, and call center met. [...] • Inform Medicaid enrollees that they will have to renew their coverage over the next year and that they should watch for mail from the Medicaid agency and respond to any requests on a timely basis. [...] People should apply for marketplace coverage and answer the applicable questions about their offer of ESI to determine whether they are now eligible for premium tax credits.16 Unfortunately, some people will lose Medicaid and not have a viable alternative for affordable health insurance because they live in one of the states that hasn’t expanded Medicaid.