Congress passed the Families First Coronavirus Response Act exactly three years ago, requiring states to keep people on Medicaid continuously enrolled throughout the coronavirus public health emergency. The Biden administration announced in January that the emergency declaration was to end on May 11, which will allow states to begin rolling out Medicaid extensions.
The Commonwealth Fund report found that uninsured rates fell in every state in the first two years of the pandemic among black, Hispanic and white adults, narrowing the disparity in coverage between the groups.
Uninsured rates for black and Hispanic adults fell by two percentage points or more in 14 and 19 states respectively. However, a majority of states saw no change in uninsured rates for black adults or had no data available. The report noted that white adults experienced modest improvements in health care coverage in nearly every state.
The organization’s study cited four reasons for the improved coverage: smaller than expected declines in employer coverage, extensions under the Affordable Care Act, mandates issued by the the family-first coronavirus response and the enhanced premium tax credits made available through the US bailout.
The Centers for Medicare & Medicaid Services are asking states to develop operational plans for winding down Medicaid extensions, and Medicaid has issued guidance on a 12-month winding down period after the public health emergency ends. State Medicaid and Children’s Health Insurance Program (CHIP) agencies will be allowed to begin their wind-up periods one month before the end of the public health emergency, the same month it ends, or one month after.
“Despite this progress, key health outcomes such as life expectancy and maternal mortality have worsened during the pandemic, particularly for people of color,” the report said. “Achieving full equity in insurance coverage is critical to reversing these trends, especially as some COVID-19 treatment and testing benefits are set to end when the public health emergency ends in may.”
The study authors noted that 11 states have not expanded Medicaid. They advised Congress to create a “federal fallback option for those eligible for Medicaid in these states.”
The Department of Health and Human Services (HHS) estimates that up to 15 million Medicaid and CHIP enrollees could lose coverage as the public health emergency ends. About 6.8 million people could lose their coverage despite still being eligible.
“Blacks and Hispanics are disproportionately enrolled in Medicaid and therefore at particular risk of losing coverage as states begin to redetermine eligibility on April 1, 2023,” the Commonwealth Fund report said.
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