Volume 5, Number 42

CONTINUOUS MEDICAID ENROLLMENT PROVISION ENDS MARCH 31

Medicaid enrollment increased significantly during the pandemic, and individuals were kept on Medicaid without requiring the annual or periodic Medicaid eligibility recertification process that existed prior to the pandemic.

At the start of the pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA), which included a requirement that Medicaid programs keep people continuously enrolled through the end of the month in which the COVID-19 public health emergency (PHE) ends, in exchange for enhanced federal funding. Primarily due to the continuous enrollment provision, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped.

But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage. As part of an end-of-the-year spending bill, signed into law on December 29, 2022, Congress set an end to the continuous enrollment provision on March 31, 2023, and phase down the enhanced federal Medicaid matching funds through December 2023. States that accept the enhanced federal funding can resume disenrollments beginning in April but must meet certain reporting and other requirements during the unwinding process.

Read more about this here.

Each state that accepted enhanced federal funding must develop a plan. Florida’s Department of Children and Families will begin reviewing the eligibility of 4.9 million Floridians currently on the Medicaid program in March, and the reviews will be completed by April 2024. The first termination of those found to be ineligible or who fail to complete the renewal process will be April 31, 2023. It’s expected that a significant number of Floridians formerly enrolled in Medicaid will be disenrolled from that program. 

This Q&A explains why so many Florida parents and caregivers are likely to lose Medicaid eligibility when the continuous coverage requirement ends; their coverage options; and how they can prepare. ​Read Q&A  

Some members of these groups will likely be affected when the extended Medicaid coverage requirement ends:

• ​Parents & Caregivers who no longer have any child(ren) under age 18​
• Youth who turned 19-20
• Aged and disabled individuals now on Medicare​
• Former foster children who turned 26
• Medically Needy Recipients

The most important message for Medicaid recipients NOW is to update their information, including their address, on the Department of Children and Family’s ACCESS website.  

Terminated individuals will receive 60 days’ advance notice from the Department of Children and Families and may be eligible for another health coverage option, e.g. an Affordable Care Act plan, another type of Medicaid, or enrollment in a different Medicare Advantage plan..

If you’re contacted by the Department of Children and Families to provide income information it’s VERY important that you provide it, as failure to provide the information will result in your Medicaid disenrollment. You must fall within Florida’s guidelines for income and assets to continue to be eligible for Medicaid. Terminated individuals and families who aren’t eligible for Medicare and whose income is at least 100% of the Federal Poverty Level may qualify for a special enrollment period to enroll in an Affordable Care Act plan, and Medicare-eligible individuals may be eligible to enroll in a different Medicare Advantage plan and/or a different level of Medicaid.

Please contact us at 561-734-3884 (individuals not eligible for Medicare) or 561-734-3884 (Medicare eligibles) if you have any questions or receive notice of termination or change of level of Medicaid coverage.

MEDICAL DEBT HAS DECLINED 18% SINCE 2020

The number of people with medical debt on their credit reports fell by 8.2 million—or 17.9%—between 2020 and 2022, according to a February 14 report from the Consumer Financial Protection Bureau (CFPB).

White House officials said in a separate draft report that the two-year drop likely stems from their policies. Among the programs they say contributed to less debt was an expansion of the Affordable Care Act, which added 4.2 million people with some form of health insurance. Also, local governments are leveraging $16 million in coronavirus relief funds to wipe out $1.5 billion worth of medical debt.

There has also been a persistent effort by the CFPB to reduce medical debt. The major credit rating agencies said last year that they will no longer include in their reports medical debts under $500 or debts that were already repaid. The agencies will also extend the time it takes to add medical debt to reports from six months to one year, possibly giving families more time to repay before being penalized with lower credit scores.

White House officials said the decline in debt could reduce fears about medical bills that can prevent people from making needed doctor appointments and filling pharmaceutical prescriptions.

While economic measures such as the unemployment rate and inflation can swing up and down, the decline in medical debt shows that steady progress is being made. Some 13.5% of the 279 million people with credit reports had at least one medical debt, down from 16.4% in 2020 and 19.4% in 2014.

Still, unpaid medical bills account for more than half of all debt in collections, according to the White House report. As a result, medical debt exceeds credit cards, personal loans, and utilities and phone bills combined.

There is also evidence that the decline predates Joe Biden's presidency. The amount of medical debt on credit reports fell to $111 billion from $143 billion between 2018 and the first half of 2021, according to a March 2022 report by the CFPB.

Some communities such as Chicago, New Orleans, Pittsburgh and Toledo, Ohio, are using $16 million in funds from 2021 COVID-19 relief funds to buy medical debt and forgive it. So far, the spending plans are eliminating $1.5 billion in medical debt, a ratio of about 100-to-1 for the expenditures by the local governments.

CHECK YOUR MAIL FOR FORM 1095-A

Where’s my Form 1095-A?

• You should have received Form 1095-A in the mail.
• Keep it with your important tax information, like W-2 forms and other records.
• Form 1095-A comes from healthcare.gov and not the IRS.
• It may be available online in your HealthCare.gov account. Learn how to find it.

How to use Form 1095-A

• Before you do anything, make sure Form 1095-A is correct. It includes information about any Marketplace plans (on healthcare.gov) that members of your household had last year.
• If anything about your coverage or household is wrong, contact the Marketplace Call Center. Don’t file your federal taxes until you’re sent a corrected version.
• Once you’ve verified its accuracy, use the information from your Form 1095-A to “reconcile” any premium tax credit for all household members.

About Paul Cholak

Paul has over forty years of benefits experience and has been Director of Employee Benefits for large companies, as well as a benefits consultant with major consulting firms. He understands the health and life insurance needs of individuals and families of all ages. He also has considerable experience in selling health and life insurance to employer groups.

He guides you through the steps of getting health and/or life insurance and is available to help you both BEFORE and AFTER you've made your purchase decision.