Key Takeaways

• The COVID-19 public health emergency (PHE) will likely be extended beyond January 11, 2023.
• Centers for Medicare & Medicaid Services (CMS) and Urban Institute research showed that many people are not aware of the upcoming return of regular Medicaid renewals. This research highlights the importance of outreach and information campaigns, clear terminology in messaging, and the use of automated renewal processes.

On December 7, 2022, CMS held its seventh monthly webinar on unwinding the PHE flexibilities for Medicaid and Children’s Health Insurance Program (CHIP) eligibility. CMS will post a recording and transcript of the webinar to the CMS National Stakeholder Calls webpage. Additional resources on unwinding the PHE can be found here for states and providers and here for Medicaid and CHIP enrollees. The next webinar will be held on January 25, 2022, at 12:00pm EST. Stephanie Costello (CMS), led the call, with remarks from Clarese Astrin (CMS), Jennifer Haley (Urban Institute), and Jessica Stephens (CMS).

In March 2020, federal legislation established the “continuous enrollment condition,” which provided states with extra federal Medicaid funding in exchange for maintaining enrollments for all individuals through the end of the month the federal PHE ends. Many states implemented comparable policies that had a similar impact on CHIP. When the PHE ends, twenty million or more enrollees could lose their Medicaid or CHIP coverage. The Department of Health and Human Services (HHS) intends to give at least 60-days’ notice prior to the end of the PHE. When the PHE ends, states will have 12 months to initiate renewals. HHS most recently renewed the PHE on October 13, 2022, and it is slated to end on January 11, 2023.

Stephanie Costello began the call with an overview of the current status of the PHE. She said that since HHS previously committed to providing 60-days’ notice before terminating the PHE, and the 60-day mark passed on November 11 with no notification, the PHE will likely be extended until mid-April if the Biden Administration follows past practice. Ms. Costello recommended that states use the additional time to prepare for the unwinding.

Clarese Astrin outlined CMS’s Consumer Research used to inform HealthCare.gov outreach to people who no longer have Medicaid. CMS distributed an attitude and awareness survey to 406 beneficiaries in May 2022 and organized focus groups of English and Spanish speaking beneficiaries to test messaging in August 2022. Survey findings indicated that many people are not hearing about re-enrollment or re-determination; only about one-third of respondents reported hearing about it. Research also showed that effective outreach plans should address plans’ affordability with specific dollar messaging as well as mention their high quality and the services covered. These findings also show that African American people were the most skeptical and will need targeted outreach, and Spanish-speaking people found the inclusion of the concept of “family” compelling.

Jennifer Haley then provided an overview of the Urban Institute’s recent consumer awareness report, Most Adults in Medicaid-Enrolled Families are Unaware of Medicaid Renewals Resuming in the Future. Researchers used Health Reform Monitoring Survey data from June 2022 to survey nearly 9,000 adults aged 18 to 64 enrolled in Medicaid or with a spouse, partner, or child enrolled. When asked about the upcoming return to regular Medicaid renewals, the Urban Institute found that 62 percent knew nothing, 15.7 percent new a little, 16.2 percent knew some, and five percent knew a lot. Researchers found that people primarily heard of the change through social media or media, followed by a state agency. This research highlights the importance of outreach and information campaigns, clear terminology in messaging, and the use of automated renewal processes.

The call closed with a brief question and answer session. Jessica Stephens additionally mentioned the Medicaid and CHIP Continuous Enrollment Unwinding Toolkit and Frequently Asked Questions for states and partners.

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This Applied Policy® Summary was prepared by Marlowe Galbraith with support from the Applied Policy team of health policy experts. If you have any questions or need more information, please contact her at mgalbraith@appliedpolicy.com or at 610-937-8378.