WASHINGTON, DC – Former Health and Human Services (HHS) Secretary Alex Azar declared a COVID-19 Public Health Emergency (PHE) in January 2020. In March 2020, Congress passed the Families First Coronavirus Relief Act.
Medicaid funding by states increased by 6.2% and Children’s Health Insurance Program (CHIP) increased by 4.34%. HHS administers the CHIP program, which matches states to provide health insurance coverage for families with children.
“We have a lot of people out of work and businesses going out of business. It’s very common. When we have a recession, the federal government provides more Medicaid funding,” Joan Alker said. She is executive director and co-founder of the Center for Children and Families (CCF) and a research professor at Georgetown University’s McCourt School of Public Policy.
Medicaid enrollment jumped 20% during the pandemic. (See chart.)
Alker said the increase in the federal government’s share of Medicaid is conditional. If states accept the money, they cannot lower their eligibility levels for children and families.
States have done this in the past, she said. “They’ll pocket the money, but they’ll cut people off from coverage,” she said. Tennessee has always been one of those bad actors. If they take federal money during the COVID emergency, states can’t make it harder to enroll by raising premiums, and once people enroll, they keep Medicare unless they choose to stop it.
“It tells us as a country that we can provide our families with ongoing insurance, which is very important at a time when families are struggling with rising food costs and rising gas prices…they don’t have to worry about big medical bills. We know that medical debt is often the number one cause of bankruptcy. So there’s really value in having that protection, and I think it’s a lesson to be learned and a silver lining in the pandemic,” Alker said.
According to the Georgetown University Center for Children and Families, about half of the 80 million people currently insured through Medicaid or CHIP are children. Medicaid enrollment has increased under the relief bill, but an estimated 6.7 million children will lose coverage when the continuous coverage requirement expires. This is likely to happen sometime this year.
PHE will run until July 15, 2022. It may be extended for another 90 days until October 15th. States could withhold additional funding, and Congress could act on a specific date to eliminate Medicaid continuation coverage. The Biden administration said it would notify states 60 days in advance if they planned to cancel the PHE.
When it ends, Medicaid enrollees will be covered at the end of the month. Then, Medicaid Maintenance of Eligibility (MOE) requirements will resume, and states will have 12 months to check the eligibility of all 80 million people currently enrolled in Medicaid. Here’s the catch: The extra funding will run out by the end of the fiscal quarter.
“An estimated 14 million people nationwide lose Medicaid coverage within a year of the emergency ending,” Mayra Alvarez said. She is president of The Children’s Partnership, a California nonprofit dedicated to health and technology issues for underserved children.
Alvarez said a drop in enrollment in Medicaid health care will disproportionately affect children of color who are more likely to rely on Medicare. Seventy-five percent of the more than 5 million children in the medical profession are people of color, she said.
“Even before the pandemic, long-standing structurally racist policies and practices had created an environment where families of color experienced greater levels of instability in everything from employment to income to housing. These economic and housing conditions increase the risk of Medicare disruption and remove the security that Medicare brings,” Alvarez said.
“The first few years are when 90 percent of a child’s brain development occurs, so the path to a child’s healthy development depends on those frequent and timely visits and checkups from healthy children,” she added.
Alvarez said keeping kids safe is the right thing to do, so she and other health advocates are supporting AB2402, which would “allow children enrolled in medical care to stay in school without having their families jump through administrative hurdles” And let them participate in the 5-year-old.”
Last week, the bill passed unanimously by the California Assembly Appropriations Committee. Next, the plenary will debate the bill, and if passed, it will go to the California Senate.
“When 3 out of 4 medical children are children of color, we have an opportunity to advance an anti-racist approach to medical registration for our state that removes barriers for families and gives every child a healthy start , first and foremost to ensure that coverage is stable and continuous,” she said.
If AB2402 becomes law, every child enrolled in medical care will be able to have 14 Healthy Child Exams before the age of 5.
“We know that when we combine distractions with onerous administrative requests to fill out forms and certify eligibility, we risk undermining the guarantees that enable our children to access those vital screenings, supports, cares for healthy growth.”
If the bill doesn’t pass, Alvarez said, advocates and the California Department of Health Care Services are notifying parents that they may have to re-register for medical care when the public health emergency ends.