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On May 25, 2022, the Centers for Medicare & Medicaid Services (CMS) held its first monthly webinar on unwinding the COVID-19 public health emergency (PHE) flexibilities for Medicaid and CHIP program eligibility.

Background

The Families First Coronavirus Response Act (FFCRA) of March 2020 established a temporary 6.2 percentage point increase in the Federal Medical Assistance Percentage (FMAP) for Medicaid programs through the end of the quarter in which the PHE ends. To qualify for this increased funding, states have had to meet stipulations on “continuous enrollment” or “maintenance of enrollment” (MOE) through the month in which the PHE ends. Many states implemented comparable policies that had a similar impact on their Children’s Health Insurance Programs (CHIP).

There are currently 78 million Americans covered through Medicaid programs—an increase of 22.2 million enrollees since the beginning of 2020. The Kaiser Family Foundation estimates that 84% of this increase is attributable to MOE.

CMS believes that up to 15 million individuals could lose Medicaid coverage after the PHE is terminated. The May webinar was the first in what will be a monthly series preparing states for the transition.

Summary

Beth Lynk, CMS, and Rachel Pryor, HHS, led the call, with remarks from CMS Administrator Chiquita Brooks-LaSure; Andrea Palm, HHS; Jessica Stephens, CMS; Erin Pressley, CMS; Jesse Cross-Call, HHS; and Stefanie Costello, CMS.

The speakers emphasized the agency’s goal of minimizing the loss of coverage once flexibilities end by ensuring individuals maintain enrollment or become enrolled in an eligible source of coverage.

When the PHE ends, states will need to resume Medicaid and CHIP eligibility renewals and end coverage for those who are no longer eligible. There will be a heavy burden on states as they address the large volume of pending renewals, likelihood of outdated mailing addresses and contact information, and workforce shortages. To reduce this burden, CMS is working closely with states to ensure their preparation for the conclusion of the PHE. Ms. Stephens stated that CMS encourages states to develop unwinding plans, obtain updated contact information from beneficiaries, launch outreach and communication plans, and engage with community partners, health plans, and the provider community.

Ms. Pressley stressed the agency’s emphasis on communication strategies to ensure beneficiaries do not lose healthcare coverage. The goal is to ensure that beneficiaries are aware of the steps they need to take to maintain enrollment or obtain an alternative form of coverage. CMS has established a national outreach campaign that engages with partners and stakeholders to achieve this goal.

The agency has also developed an Unwinding Communications Toolkit, which provides states with communication tools for outreach to beneficiaries with CHIP or Medicaid. The toolkit includes key messaging points, as well as sample fillable digital flyers, drop-in articles, social media and outreach products, emails, SMS and text messages, and call center scripts. CMS notes the value of engaging with such stakeholders as health care providers, local health departments, social services, managed care plan issuers, and community sources. Ms. Pressley highlighted the importance of states keeping beneficiaries’ contact information up to date and reminding beneficiaries to check for mail and complete renewal forms (if applicable). CMS hopes to maintain the record levels of enrollment in their healthcare programs through proactive communication with states and beneficiary outreach.

CMS will post a recording and transcript of the webinar to the CMS National Stakeholder Calls webpage. Additional resources on unwinding the PHE can be found here for states and providers and here for Medicaid and CHIP enrollees. The next webinar will be held on June 22, 2022, at 12:00pm EST, with monthly webinars scheduled through December 2022.

 Marlowe Galbraith contributed to this story.