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Continuous enrollment in Medicaid and enhanced premium assistance have helped millions afford and maintain coverage, but those gains could be reversed as the public emergency ends and if the provisions like those in the Build Back Better Act fail to pass.
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pandemic but are still eligible for coverage are at increased risk of being disenrolled if their contact information is out of date.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.
Medicaid enrollment increased since the start of the pandemic, primarily due to the continuous enrollment provision.KFF estimates that between 8 million and 24 million people will lose Medicaid coverage during the unwinding of the continuous enrollment provision.The Medicaid continuous enrollment provision stopped “churn” among Medicaid enrollees.States approaches to unwinding the continuous enrollment provision vary.
During the Medicare Part D annual enrollment period, people on Medicare can review and compare stand-alone prescription drug plans (PDPs) and Medicare Advantage plans and switch plans if they choose. Low-income beneficiaries who receive premium and cost-sharing assistance through the Part D Low-Income Subsidy (LIS) program have a subset of premium-free PDPs (benchmark plans) available to them, but can also choose to enroll in a non-benchmark plan and pay a premium. This analysis examines plan changes among LIS enrollees in PDPs between 2006 and 2010.
The Kaiser Family Foundation California Longitudinal Panel Survey is a series of surveys that, over time, tracks the experiences and views of a representative, randomly selected sample of Californians who were uninsured prior to the major coverage expansions under the Affordable Care Act (ACA). The initial baseline survey was conducted with a representative sample of 2,001 nonelderly uninsured Californian adults in summer 2013, prior to the ACA’s initial open enrollment period. The second survey in the series followed up with the same group of previously uninsured Californians who participated in the baseline (a longitudinal panel survey). The third in the series, and the focus of this report, followed up with them again after the second open enrollment period in spring 2015 to find out whether more have gained coverage, lost coverage, or remained uninsured, what barriers to coverage remain, how those who now have insurance view their coverage, and to assess the impacts that gaining health insurance may have had on financial security and access to care.
As a result of the COVID-19 Public Health Emergency (PHE) , states have experienced increased enrollment along with administrative challenges. After the PHE ends, states are likely to have renewal and redetermination backlogs and will face decisions around continuing temporary policy changes. This brief highlights key issues from the new CMS guidance to states on how to unwind emergency authorities and resume normal eligibility and enrollment operations.
This analysis summarizes recent interviews with marketplace navigators and other consumer assistance professionals, who offered observations about the 2021 Open Enrollment period, discussed general and pandemic-specific challenges facing consumers seeking coverage, and offered suggestions to improve enrollment outcomes. The brief also reviews information about federal marketplace resources and spending priorities contained in Trump Administration budget documents, and possible sources of funding for a COVID-19 special enrollment period during the Biden administration.
This data note discusses changes in the number of applications for Medicaid/CHIP coverage during the coronavirus pandemic. Although enrollment in Medicaid/CHIP has increased steadily by more than 6 million individuals (9%) from February to September 2020, the total number of Medicaid/CHIP applications has decreased by more than 150,000 (-6%) in the same time period. The decline in applications might on the surface suggest that fewer people are applying for coverage even in the face of large job and income losses, but data limitations – in particular, the fact that application statistics do not distinguish between new signups and renewals – make it difficult to draw any clear conclusions.
President Biden’s January 28th executive order to reopen enrollment in the federal ACA Marketplace from February 15 through May 15, combined with $50 million in federal spending on outreach and education about ACA coverage options, has the potential to reach millions of people who were uninsured prior to or have lost coverage during the pandemic. As of 2019, there were 29 million non-elderly uninsured people, and the majority (57%) were eligible for financial assistance through the ACA Marketplaces (33%) or Medicaid (25%). KFF estimates indicate that nearly nine million uninsured people could be eligible for free or subsidized Marketplace coverage during the new enrollment period. Importantly, these actions to facilitate enrollment in ACA Marketplace coverage will also likely lead eligible low-income people to enroll in Medicaid coverage.
This post provides details about the ongoing Special Enrollment Period to sign up for health coverage on the ACA exchanges, including who is eligible to enroll, how costly Marketplace insurance is on average, and what other factors will affect enrollment during this period.
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