Summary
With the expiration of the continuing resolution (P.L. 117-70) funding the federal government one month away (February 18), top congressional appropriators appear to be nearing a deal on a fiscal year (FY) 2022 omnibus government funding bill. Whether a COVID-19 supplemental package will be bundled with the FY 2022 funding bill remains an open question, as congressional Democrats wait for guidance from the Biden Administration.
Since passing another COVID-19 bill would require bipartisan support, any additional funding would likely be narrow in scope. The package could focus on issues such as equipping schools with the needed resources to remain open, bolstering the COVID-19 testing supply chain, and providing support to hospitals facing staffing shortages and nearing capacity limits. However, top congressional Republicans have expressed skepticism toward additional appropriations, pointing to unspent appropriations for testing and other supplies available to the Departments of Health and Human Services (HHS) and Education.
As for available COVID-19 resources, 500 million at-home COVID-19 tests will be available to order tomorrow at COVIDTests.gov or through a call line. Every home in the U.S. can order up to four tests. They will be shipped within 7 to 12 days of ordering through the U.S. Postal Service. In addition, the White House is expected unveil more details this week on “how we’re making high-quality masks available to the American people for free,” according to remarks delivered by President Biden last week. The President is scheduled to speak about the COVID-19 response on Thursday.
Centers for Medicare and Medicaid Services (CMS)
Today, Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure will provide updates on the Biden Administration’s “strategic vision” for the agency, key 2021 accomplishments, and considerations for 2022. “CMS serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes,” said Brooks-LaSure of their vision back in September 2021. Brooks-LaSure, along with other health officials, have outlined the goals for Medicare and Medicaid and CHIP. They focus on advancing health equity, expanding access to affordable coverage and care, and promoting person-centered care.
Medicaid and CHIP
Later this week, the Medicaid and CHIP Payment and Access Commission (MACPAC) will convene to discuss several timely issues:
- Medicaid Eligibility Redeterminations – States will resume Medicaid eligibility redeterminations at the end of the COVID-19 public health emergency (PHE), which is set to expire on April 16, 2022 (unless renewed again by the Biden Administration). As a condition of receiving enhanced federal funding for Medicaid – 6.2 percentage point bump to the state’s Federal Medical Assistance Percentage (FMAP) – states must keep individuals enrolled in Medicaid throughout the PHE. States will have up to 12 months after the month in which the PHE ends to complete verifications, redeterminations, and renewals. However, the enhanced FMAP for the continuous coverage requirement, as well as other maintenance of eligibility requirements, would expire at the end of the quarter in which the PHE ends (i.e., before the 12 months are up).
Medicaid advocates are concerned that the loss of enhanced federal funding during the wind-down process would increase the risk for coverage loss, as states undertake the herculean task of processing millions of redeterminations. The latest figures show Medicaid enrollment grew (16.8 percent) from 12.0 million in February 2020 to 83.2 million in June 2021, according to the Kaiser Family Foundation.
- Dually Eligible Beneficiaries – MACPAC will discuss their comments in response to provisions affecting dual-eligible special needs plans (D-SNPs) in the Contract Year (CY) 2023 Policy and Technical Changes to Medicare Advantage (MA) and Part D proposed rule. CMS proposes several changes to the definitions of fully integrated dual eligible special needs plans (FIDE SNPs) and highly integrated dual eligible special needs plans (HIDE SNPs) that are intended to promote integration of Medicare and Medicaid (WHG summary). Comments are due March 7. Commissioners will also continue to their discussions on how to better integrate care for dually eligible beneficiaries.
In addition, MACPAC will discuss recommendations for upcoming 2022 reports:
- Policy options for improving vaccination rates among adult Medicaid beneficiaries (March Report);
- Money Follows the Person qualified residence criteria (March Report); and
- A new system for monitoring access to care among Medicaid beneficiaries (June Report).
Lastly, MACPAC will hear from panelists on how to improve beneficiary engagement and elevate consumer voices in Medicaid policymaking, which are top priorities for CMS Administrator La-Sure. CMS is slated to issue major rules affecting Medicaid enrollment and access to health care:
- A proposed rule that would streamline eligibility and enrollment processes for all Medicaid and CHIP populations and create new enrollment pathway (April 2022); and
- A proposed rule that would assure and monitor equitable access in Medicaid and CHIP (October 2022).