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Unwinding the Medicaid Continuous Enrollment Provision and Returning to Regular Operations after COVID-19

Year Developed: 2023

Resource Type: Publication.

Primary Audience: Board of Directors C-Suite (CEOs, CFOs, CIOs, COOs, CMOs, etc) Clinicians Health Center Staff

Language(s): English

Developed by: Centers for Medicare & Medicaid Services (See other resources developed by this organization).

Resource Summary: The expiration of the continuous coverage requirement authorized by the Families First Coronavirus Response Act (FFCRA) presents the single largest health coverage transition event since the first open enrollment period of the Affordable Care Act. As a condition of receiving a temporary 6.2 percentage point Federal Medical Assistance Percentage (FMAP) increase under the FFCRA, states have been required to maintain enrollment of nearly all Medicaid enrollees. When the continuous coverage requirement expires, states will have up to 12 months to return to normal eligibility and enrollment operations. Additionally, many other temporary authorities adopted by states during the COVID-19 public health emergency (PHE), including Section 1135 waivers and disaster relief state plan amendments (SPAs), will expire at the end of the PHE, and states will need to plan for a return to regular operations across their programs. CMS will continue to update this page as additional tools and resources are released.

Resource Topic: Emerging Issues, Clinical Issues, , Health Equity

Resource Subtopic: COVID-19, Population Health, , Social Determinants of Health (SDOH).

Keywords: Medicaid.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $6,625,000 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.