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HHS Urges States to Address Medicaid Coverage Loss Among Children

HHS Secretary Xavier Becerra urges nine states with high rates of children dropped from Medicaid to adopt federal options and address coverage losses. The push includes utilizing CMS-provided flexibilities and removing barriers to ensure comprehensive health coverage for eligible children.

HHS Secretary Xavier Becerra sent letters to nine states with the highest coverage losses among children on Monday. | Alex Wong/Getty Images

In an effort to address the alarming rate of children dropped from Medicaid in certain states, Health and Human Services (HHS) Secretary Xavier Becerra sent letters to nine governors urging them to utilize federal rules and options provided by the Centers for Medicare & Medicaid Services (CMS) to reinstate coverage. The states targeted for action include Arkansas, Florida, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota, and Texas.

Federal Options for Coverage

HHS Secretary Becerra encouraged states to adopt more of the 400 options offered by CMS to facilitate coverage renewal. These options include utilizing enrollee information for auto-renewal and extending the enrollment period. HHS issued new guidance on Monday, introducing an option that allows an additional 12 months for children to enroll, applicable until 2024.

Specific Requests to States

Becerra outlined specific requests to the states, including the removal of barriers to Children’s Health Insurance Program (CHIP) enrollment for children transitioning from Medicaid, reduction of call center times, and expansion of Medicaid programs if not already done. The emphasis is on preventing children from losing coverage due to bureaucratic challenges and ensuring eligibility criteria are met.

Impact of State Choices

Highlighting the significance of state choices, CMS Deputy Administrator Daniel Tsai emphasized that states embracing CMS policy flexibilities have been more effective in safeguarding children’s coverage. HHS data revealed that the nine states in question were responsible for 60 percent of children’s coverage losses between March and September.

Disparities between Medicaid Expansion and Non-Expansion States

The data further illustrated disparities between states that expanded Medicaid and those that did not. Non-expansion states, accounting for 10 states like Alabama, Florida, Georgia, and Texas, had higher disenrollment rates, with youth turning 19 during the COVID-19 public health emergency being disproportionately affected.

Background and HHS Warnings

The coverage losses followed the mandatory eligibility reviews after the end of the public health emergency in May. In August, HHS warned states about potential violations of federal requirements, citing issues such as long wait times at call centers and disenrollments due to paperwork problems. CMS later identified errors by states that led to the mistaken loss of coverage for half a million individuals, prompting corrective actions.

In a concerted effort to address these challenges, HHS is urging proactive measures from states to ensure comprehensive health coverage for all eligible children.

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