Consumer / Employer, Legal

HHS: Medicaid/CHIP Coverage To Be Reinstated for 500K People

Thirty states have been conducting Medicaid and CHIP automatic renewals incorrectly, leading to many individuals being wrongly removed from coverage. Because of this, nearly 500,000 children and other individuals will have their coverage reinstated.

Medicaid, coverage,

After determining an issue in the way many states were handling Medicaid and CHIP redeterminations, the U.S. Department of Health and Human Services (HHS) announced Thursday that coverage will be reinstated for nearly 500,000 children and other individuals.

“Thanks to swift action by HHS, nearly half a million individuals, including children, will have their coverage reinstated, and many more will be protected going forward. HHS is committed to making sure people have access to affordable, quality health insurance – whether that’s through Medicare, Medicaid, the Marketplace, or their employer,” said HHS Secretary Xavier Becerra in a statement. “We will continue to work with states for as long as needed to help prevent anyone eligible for Medicaid or CHIP coverage from being disenrolled.”

The continuous enrollment provision — which prevented states from disenrolling Medicaid enrollees during the Covid-19 public health emergency — ended in March, and states are returning to the typical renewal process. But the transition hasn’t been entirely smooth.

In August, the Centers for Medicare and Medicaid Services (CMS) sent a letter to states and U.S. territories notifying them of an eligibility systems issue in regards to automatic renewals. Automatic renewals are when states automatically renew a member if they determine the individual is still eligible for Medicaid or CHIP through available information like state wage data. However, some states were conducting auto-renewals at the family level instead of the individual level, even though different family members will have different eligibility statuses. Children, for example, often have higher eligibility thresholds than adults do and could still be eligible for Medicaid or CHIP even if their parents aren’t.

CMS determined that as of Thursday, 30 states and territories reported having this issue, and all of these states must pause procedural disenrollments (when a member’s coverage is terminated because they did not complete the renewal process but may still be eligible) for those who are affected. Another 23 states and territories reported that they are conducting automatic renewals correctly.

“Medicaid and CHIP are essential for millions of people and families across the country,” said CMS Administrator Chiquita Brooks-LaSure in a statement. “Addressing this issue with auto-renewals is a critical step to help eligible people keep their Medicaid and CHIP coverage during the renewals process, especially children. CMS will keep doing everything in our power to help people have the health coverage they need and deserve.”

So far, nearly 7.2 million Medicaid enrollees have been disenrolled from coverage during the unwinding of the continuous enrollment provision, according to KFF. About 73% of all people disenrolled were removed from coverage for procedural reasons. KFF noted that data on children are limited, but children represented 42% of Medicaid disenrollments in the 16 states reporting age breakouts.

Photo: designer491, Getty Images