The Centers for Medicare & Medicaid Services (CMS) sent a letter to state health officials Friday reminding states they must provide 12 months of continuous coverage to children under the age of 19 on Medicaid and the Children’s Health Insurance Program (CHIP) beginning Jan. 1, 2024.
Federal health agencies insist providing continuous care will support short- and long-term health outcomes, as required by the Consolidated Appropriations Act of 2023, noting that coverage could extend past 12 months if requested under Section 1115 of the Social Security Act.
"Children should always have access to health care services. No exceptions. Thanks to the actions taken by the Biden-Harris Administration, states must provide all children with Medicaid and CHIP continuous coverage for 12 months,” said Department of Health and Human Services Secretary Xavier Becerra. “This important action will ensure children have access to the preventative and primary care they need to be healthy and thrive. We will continue to support children and their families, whenever and however it is needed.”
“CMS continues to work to increase access to health care services for children in ways that reduce disparities and build a reliable health safety net for every young person,” said CMS Administrator Chiquita Brooks-LaSure in a statement. “Families of children enrolled in Medicaid and CHIP will have peace of mind knowing their children will have uninterrupted access to health care coverage for a year, regardless of any changes in their family’s financial circumstances.”
Continuous eligibility provides coverage to children in both programs for one year regardless of changes in circumstances such as income or household composition or loss of supplemental security income. Research cited by CMS finds that children who are disenrolled are more likely to experience poor healthcare outcomes. Continuous eligibility also reduces financial barriers to care for low-income families, according to a Georgetown University report.
CMS noted that states will still be undergoing the redetermination process when continuous eligibility becomes effective.
According to data released Friday, 66,064,094 people are enrolled in Medicare, nearly half of which are in Medicare Advantage plans. More than 12 million individuals are dually eligible for Medicare and Medicaid. Approximately 92 million people are enrolled in Medicaid and CHIP, a decrease of 1.2 million people since the last report.
A survey conducted by The Harris Poll found that more than one-third of Medicaid members (35%) said they were not contacted by their health plan to renew coverage. Older Medicaid members also reported that their health plans did not help them through the redetermination process at a higher rate than other enrollees.