In late 2022, Congress enacted section 5112 of the Consolidated Appropriations Act, 2023 (CAA), requiring states to provide children under age 19 determined eligible for Medicaid or the Children’s Health Insurance Program (CHIP) with 12 months of continuous enrollment (CE) effective January 1, 2024. To support states in implementing CE, the Centers for Medicare & Medicaid Services issued sub-regulatory guidance expanding on the CAA’s new requirement. This Q&A is intended to serve as an added resource for states as they newly take up CE for children or modify existing CE policies to meet the CAA requirement. As noted, some issues remain open pending further CMS guidance.

State updates as of January 26, 2024.

State updates as of January 19, 2024.

State Medicaid agencies and their partners have been executing communications campaigns focused on Medicaid renewals for almost a year. In the closing months of unwinding, states have an opportunity to apply lessons learned and fine-tune messaging to maximize communications. SHVS conducted a rapid message test to gauge the persuasiveness of message themes to inform final unwinding communications, with the intention that these findings will continue to be useful as states return to routine renewal operations beyond the unwinding. This expert perspective highlights findings from the rapid message test and includes recommendations for states to refine or develop effective communications campaigns.

During the unwinding of the Medicaid continuous coverage requirement there has been a strong focus on monitoring the impacts of eligibility redeterminations. A review of public unwinding data identified 11 states that are voluntarily reporting Medicaid reinstatement data—including reinstatements as a result of CMS guidance on conducting ex parte at the individual level, as a result of fair hearing cases, or re-enrollment into Medicaid and the Children’s Health Insurance Program within the 90-day reconsideration period. This expert perspective reviews current state reporting of reinstatement data and provides recommendations for the reporting of such data.

State updates as of January 12, 2024.

State updates as of January 5, 2024.

States use a variety of approaches to encourage, require, and incentivize Medicaid managed care (MMC) entities to identify and address unmet social needs that can contribute to poor health outcomes, lower quality care, and higher medical expenditures. This expert perspective highlights updates to the Addressing Health-Related Social Needs Through Medicaid Managed Care toolkit which describes 8 different health-related social needs approaches across 20 state MMC programs.

This expert perspective highlights 10 resources published this year by State Health and Value Strategies that showcase the innovative and hard work states are engaged in to transform healthcare. While unwinding the Medicaid continuous coverage requirement has consumed much of states’ time and attention, states have also forged ahead with innovative efforts to expand coverage, improve care, meaningfully engage the diverse communities they serve, and advance health equity. This list of 10 SHVS resources celebrate what states have accomplished and highlight policy opportunities other states may look to for inspiration. 

On December 18, 2023, the Centers for Medicare & Medicaid Services released a suite of Medicaid unwinding-related guidance and enrollment data that includes a focus on ensuring eligible children maintain Medicaid and Children’s Health Insurance Program coverage. This expert perspective reviews the children-specific resources and the broader unwinding-related resources included in this release.