Dive Brief:
The Biden administration has approved waivers for five states to keep children continuously enrolled in Medicaid and the Children’s Health Insurance Program for more than a year.
In Colorado, children can now be continuously eligible for the safety-net programs until their third birthday, the CMS said last week. Kids in Hawaii, Minnesota, New York and Pennsylvania can be continuously enrolled until their sixth birthday.
But the future of multiyear continuous eligibility is unclear under the incoming Trump administration, which could rescind approvals or prevent states from implementing waivers, according to a brief by the Georgetown University McCourt School of Public Policy’s Center for Children and Families.
Dive Insight:
Continuous enrollment ensures beneficiaries don’t suddenly lose access to care if their financial circumstances change, while reducing administrative burden for states, according to the CMS.
Under the latest waivers, Colorado and Pennsylvania will also provide a year of continuous eligibility for some people ages 19 through 64 who were recently incarcerated. Hawaii will offer two years of ongoing enrollment for children ages six through 19, while Minnesota will provide a year of continuous eligibility for people ages 19 through 21.
It’s the latest move from the Biden administration to expand continuous eligibility for Medicaid. Though all states are required to continuously cover children in Medicaid and CHIP for one year, the CMS has approved nine other state requests to expand continuous eligibility for specific groups.
Continuous enrollment policies could also help avert disenrollments for administrative reasons — a significant challenge during Medicaid redeterminations, according to Elisabeth Wright Burak, a senior fellow at Georgetown’s CCF.
States began rechecking enrollees’ eligibility for Medicaid last year after a period of continuous enrollment during the COVID-19 pandemic. Millions of Americans have been removed from the program since.
Nearly 70% of disenrollments during the unwinding period were for procedural or paperwork reasons, suggesting some of the beneficiaries who were cut from Medicaid might still be eligible, according to health policy research firm KFF.
Children were also inappropriately disenrolled due to a systems error during redeterminations last year, forcing federal regulators to pause enrollment checks in 30 states.
Further turbulence for Medicaid could be on the horizon after President-elect Donald Trump assumes office early next year. The Republican-controlled government could implement Medicaid work requirements to narrow eligibility or use block grants to limit funding.
