The Unwinding of Medicaid and How to Preserve Coverage
In March 2020, the Families First Coronavirus Relief Act (FFCRA) required the continuous coverage of anyone enrolled in Medicaid or a Medicaid expansion Children’s Health Insurance Program (CHIP). During this time, the federal government raised the federal medical assistance match percentage by 6.2% to help offset costs for the states.
As of March 31, 2023, this COVID-19 Public Health Emergency (PHE) policy and funding that kept individuals enrolled in Medicaid, regardless of whether their eligibility had changed, has ended. This means that families and children may lose coverage or be moved to new health insurance plans through Pennie, Pennsylvania's official health insurance Marketplace.
While states have the option to take up to 14 months to work through the process of redeterminations, Pennsylvania will be doing the same in 12 months.
During this time, many of the children enrolled in Medicaid and/or CHIP will lose coverage due to various procedural reasons, such as not returning re-enrollment forms by the proper dates. It is imperative for us to help our patients by educating their parents about their responsibilities for re-enrollment. While no patient will lose coverage without notice, those covered by Medicaid need to be mindful of the process required.
The American Academy of Pediatrics has provided resources to be used during this time including:
Additional resources including a webinar and accompanying slide deck are provided by our community partner, the Pennsylvania Health Access Network (PHAN), providing details for pediatricians and your staff on this redetermination process and how PHAN can directly support your patients and families in navigating this redetermination process.
The Pennsylvania Department of Health and Pennie have also worked together to provide a Communications and Outreach Toolkit designed to help you continue your outreach to patients and their families using social media images and text posts as well as phone scripts that can be used by office staff.
In addition to the redetermination process, the PA CHIP program has another big change coming as of April 17th. As of this date, CHIP families and all new enrollees will need to go through DHS/County Offices of Assistance instead of their CHIP health insurance plan to determine eligibility.
Our community partners, Pennsylvania Partnerships for Children, have created a few resources that can be used to inform families about this specific changes to CHIP including:
If you have questions about the redetermination process or shift in CHIP enrollment, or have questions from your patients' families, please reach out to us at [email protected].
As of March 31, 2023, this COVID-19 Public Health Emergency (PHE) policy and funding that kept individuals enrolled in Medicaid, regardless of whether their eligibility had changed, has ended. This means that families and children may lose coverage or be moved to new health insurance plans through Pennie, Pennsylvania's official health insurance Marketplace.
While states have the option to take up to 14 months to work through the process of redeterminations, Pennsylvania will be doing the same in 12 months.
During this time, many of the children enrolled in Medicaid and/or CHIP will lose coverage due to various procedural reasons, such as not returning re-enrollment forms by the proper dates. It is imperative for us to help our patients by educating their parents about their responsibilities for re-enrollment. While no patient will lose coverage without notice, those covered by Medicaid need to be mindful of the process required.
The American Academy of Pediatrics has provided resources to be used during this time including:
- English and Spanish flyers discussing steps and resources for families looking to keep their Medicaid insurance up to date
- A Medicaid Unwinding letter template that may be filled out with your practice-specific information and given to patients and families
- A two-page informational flyer for pediatricians with key roles and tips to help keep patients enrolled in their insurance
Additional resources including a webinar and accompanying slide deck are provided by our community partner, the Pennsylvania Health Access Network (PHAN), providing details for pediatricians and your staff on this redetermination process and how PHAN can directly support your patients and families in navigating this redetermination process.
The Pennsylvania Department of Health and Pennie have also worked together to provide a Communications and Outreach Toolkit designed to help you continue your outreach to patients and their families using social media images and text posts as well as phone scripts that can be used by office staff.
In addition to the redetermination process, the PA CHIP program has another big change coming as of April 17th. As of this date, CHIP families and all new enrollees will need to go through DHS/County Offices of Assistance instead of their CHIP health insurance plan to determine eligibility.
Our community partners, Pennsylvania Partnerships for Children, have created a few resources that can be used to inform families about this specific changes to CHIP including:
- a Social Media Toolkit that is designed for outreach to patients and families
- a printable Fact Sheet that can be used as a flyer in office
If you have questions about the redetermination process or shift in CHIP enrollment, or have questions from your patients' families, please reach out to us at [email protected].