[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text]On July 27, 2022, the Medicaid and Children\u2019s Health Insurance Program Payment Advisory Commission (MACPAC) held a public meeting to provide an update on the status of Medicaid and CHIP coverage during and after the public health emergency (PHE). Topics discussed included fiscal implications of unwinding the PHE, addressing uncertainty for states, and Centers for Medicare & Medicaid Services (CMS) and state preparation to address potential post-PHE loss of coverage.<\/p>\n
Between February 2020 and February 2022, enrollment in Medicaid and CHIP increased\u00a0<\/span>by 2<\/span>4<\/span> percent<\/span>. At the end of the PHE, 5 to 14 million individuals may disenroll, though\u00a0<\/span>some may be eligible for coverage under other sources.<\/span> MACPAC is dedicated to\u00a0<\/span>reducing<\/span> potential loss of coverage for Medicaid and CHIP beneficiaries.<\/span><\/span> During the PHE, states have received<\/span> approximately $100.4 billion<\/span> in funding<\/span> due to<\/span> the\u00a0<\/span>enhanced Federal Medical Assistance Percentage (FMAP)<\/span>, which is used<\/span> to determine\u00a0<\/span>the matching funds rate allocated<\/span> annually to<\/span> CHIP.<\/span> At the end of the<\/span> PHE<\/span>, enrollment\u00a0<\/span>and total spending growth will likely be reduced, and the state share of Medicaid\u00a0<\/span>spending will likely<\/span> grow with the conclusion of the enhanced<\/span> F<\/span>MAP.<\/span> There has also\u00a0<\/span>been concern that<\/span> the end of the enhanced match would cause states to unwind\u00a0<\/span>q<\/span>uickly. To address these concerns, one commissioner suggested MACPAC make a\u00a0<\/span>recommendation for phasing down the enhanced FMAP to avoid a<\/span> funding<\/span> cliff. Some\u00a0<\/span>commissioners supported this<\/span> suggestion but<\/span> noted that the impact of the enhanced\u00a0<\/span>FMAP ending is de<\/span>pendent on<\/span> state budgets<\/span> and<\/span> fiscal health.<\/span><\/span><\/span> The state response to the eventual end of the PHE has been variable.<\/span> MACPAC noted\u00a0<\/span>that states and stakeholders have been concerned that the<\/span> uncertainty surrounding the\u00a0<\/span>end of the PHE has hindered their ability to plan<\/span>; however, other states and\u00a0<\/span>stakeholders have said they have developed unwinding plans and are making broader\u00a0<\/span>system and process changes.<\/span> While additional advanced notice or<\/span> provi<\/span>ding a<\/span> certain\u00a0<\/span>date for unwinding would give states more time to prepare,<\/span> several states indicated\u00a0<\/span><\/span>that additional notice would not substantially improve preparation<\/span> efforts<\/span>.<\/span> S<\/span>tates also\u00a0<\/span>noted that<\/span> shifting<\/span> the<\/span> end date<\/span> of the PHE causes states to s<\/span>tart and stop<\/span> preparation\u00a0<\/span>and<\/span> burdens state resources.<\/span><\/span><\/p>\n
<\/span><\/p>\nFiscal Implications of<\/span> Unwind<\/span>ing the PHE<\/span><\/span>
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<\/span><\/p>\nUncertainty of PHE End<\/span> Impacts State Planning Efforts<\/span><\/span>
<\/span><\/h3>\n<\/span>MACPAC Outlines<\/span> Priorities<\/span> in Preparation for Upcoming Meeting<\/span><\/span>
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