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Even as the ninth annual Open Enrollment period gets underway, the Affordable Care Act (ACA) Marketplaces continue to evolve and important changes are expected. This issue brief discusses what changes to watch out for in the coming enrollment period.
Recent policy actions and proposals in Medicaid have renewed focus on the problem of churn, or temporary loss of coverage in which enrollees disenroll and then re-enroll within a short period of time. We find that 10% of full-benefit enrollees have a gap in coverage of less than a year, and rates are higher for children and adults compared to aged and people with disabilities. Churn has implications for access to care as well as administrative costs faced by states.
For more than a year-and-a-half, the continuous enrollment requirement tied to enhanced Medicaid funding during the COVID-19 pandemic has all but halted enrollment “churn,” the temporary loss of coverage in which people disenroll from Medicaid and then re-enroll within a short period of time.
The COVID-19 pandemic has magnified pre-existing health disparities for justice-involved populations, with coronavirus infection rates among incarcerated populations higher than overall infection rates in nearly all states. Justice-involved individuals are disproportionately low-income and often have complex and/or chronic conditions, including behavioral health needs. Although the statutory inmate exclusion policy prohibits Medicaid from covering services provided during incarceration (except for inpatient services), states may take other steps to leverage Medicaid to improve continuity of care for justice-involved individuals.
As 2022 kicks off, a number of issues are at play that could affect coverage and financing under Medicaid. This issue brief examines key issues to watch in Medicaid in the year ahead.
Once states resume redeterminations and disenrollments at the end of the public health emergency (PHE), Medicaid enrollees who moved within a state during the pandemic but are still eligible for coverage are at increased risk of being disenrolled if their contact information is out of date. We analyzed federal survey data for 2020 and found that roughly 1 in 10 Medicaid non-elderly enrollees (9%) moved in-state in 2020. A much smaller share, just 1%, moved to a different state in the U.S. Individuals that move within state may continue to be eligible for Medicaid, while a move out of state would make them no longer eligible for Medicaid coverage in their previous residence. States can take a number of actions to update enrollees’ addresses and other contact information to minimize coverage gaps and losses for eligible individuals after the end of the PHE, particularly for individuals who may have moved within a state.
As states plan for the end of the COVID-19 public health emergency, the resumption of eligibility redeterminations and disenrollments when the continuous Medicaid enrollment requirement is lifted could lead to coverage disruptions and losses, according to a new KFF 50-state survey.
In this issue brief, we estimate rates of Medicaid coverage loss among people who became Medicare-Medicaid enrollees (MMEs) during 2018 but did not have any months of MME coverage in the prior year. We compare outcomes for partial-benefit MMEs and full-benefit MMEs.
Unlike previous recessions in modern history, this past recession was spurred by the spread of a virus (COVID-19), which created a public health crisis with unique health implications. This brief describes the broader impacts of this most recent recession – which lasted from February 2020 to April 2020 -- and also explores how trends in Medicaid spending and enrollment differed from past recessions and what that might mean for state Medicaid programs moving forward.
Provisions in the Families First Coronavirus Response Act (FFCRA) require states to maintain continuous Medicaid enrollment for enrollees until the end of the month when the COVID-19 public health emergency (PHE) ends. When the continuous enrollment requirements end and states resume redeterminations and disenrollments, individuals with LEP may be at increased risk of losing Medicaid coverage or experiencing a gap in coverage due to barriers completing these processes, even if they remain eligible for coverage.
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