With more than 15 million Medicaid enrollees with the potential to lose health care, the end of the public health emergency (PHE) and the national unwinding is the big story of 2023.
At the start of the COVID-19 pandemic, Congress enacted a requirement to keep individuals continuously enrolled in Medicaid programs through the end of the month of the emergency period. This requirement, bolstered by enhanced federal funding, and added flexibilities, led to substantial growth in the number of Medicaid beneficiaries across all states.
With Medicaid enrollment activities set to resume as early as April 1, 2023, states are racing to develop plans to make certain eligible beneficiaries continue to receive coverage, while those who are no longer eligible transition to alternative health plan options.
It is a daunting administrative task for states with the potential to erase historic gains in expanding health care coverage—with children and people of color most likely to be affected. Yet some states, recognizing the need to get ahead of the PHE unwinding and Medicaid renewals, are taking proactive steps to soften the blow dealt by the loss of continuous eligibility.
In Kentucky, the Department for Medicaid Services (DMS) turned to Altarum for policy expertise, operational support, and expanded implementation capacity. We are partnering with DMS to help navigate this process to ensure a smooth transition and the optimization of coverage for all Kentuckians. Through our efforts, we are guiding DMS and key stakeholders in several important areas:
- Operational Planning – strategic planning to manage all activities and service changes across DMS and partner organizations for the PHE unwinding and Medicaid renewals
- Communications – developing and promoting uniform messaging for various audiences, such as Medicaid beneficiaries, providers, state staff, and advocacy organizations
- Training and Staff Readiness – coordinating across the state to ensure staff working directly with beneficiaries, and those at advocacy organizations, have what they need to avoid potential gaps in coverage
- System Readiness – ensuring that statewide provider and beneficiary enrollment and eligibility systems are refined and prepared for changes to requirements as policies revert to pre-pandemic status
- Policy Implementation – providing Medicaid and CMS policy expertise, as flexibilities allow, during the PHE unwinding period or as they are formally established through state-level policy changes
- Stakeholder Engagement – ongoing engagement efforts to support the transition back to normal operations
With the increased capacity and expertise provided by Altarum’s support, states are better able to navigate complex policy considerations and waiver redesign while managing the shifting PHE unwinding timeline. More than that, our partnership with states helps to reduce gaps in coverage and ensure access to health care for those who need it most.
In Kentucky, more than 320,000 members are set to start the renewal process beginning in May 2023 — at least a quarter of whom are children. It’s estimated that as many as 85,400 enrollees could lose eligibility and need to be connected with a qualified health plan. By partnering with Altarum, the state has taken a significant step toward ensuring that all those served by Medicaid, as well as the staff and organizations that support them, understand the upcoming unwinding and take the steps necessary to safeguard these individuals’ access to health care.
“Through the uncertainty of the PHE timeline and the immense amount of coordination it has taken for our Team KY to prepare for the PHE Unwinding and the resumption of Medicaid renewals, Altarum’s support and expertise has been invaluable. We feel confident with their collaboration that we will make it through this transition ensuring seamless health insurance coverage for Kentuckians.”
Veronica Jucy-Cecil, Deputy Commissioner, Kentucky Department for Medicaid Services (DMS)