Biden admin to let Covid Medicaid extensions lapse April 1

During the COVID-19 pandemic state of emergency, states were prohibited from kicking people off the Medicaid program. However, legislation tucked away in the enormous omnibus bill passed by Congress last week winds down funding to pay for the additional enrollees and allows states to boot people off the program, as of April 1.

The legislation comes as good news to Republican governors, who last week sent a letter to President Biden asking him to make these changes over concerns about inflated Medicaid enrollment.

"This is a positive for states in terms of planning, however, this will come at the cost of some individuals losing their health care," said Massey Whorley of the health consulting firm Avalere.

The Medicaid program currently provides health coverage to nearly 80 million low-income Americans. Many of the people poised to be bumped from the program will be eligible for coverage through their employers, the Affordable Care Act, or, in the case of kids, the Children’s Health Insurance Program.

Advocates are concerned about how easily and quickly people could be notified of their ineligibility and whether they'll be given adequate information regarding their options. States will be required to notify enrollees first before kicking them off, but some of the country’s poorest people may not have a stable home address or access to internet or phone services to receive a timely notification or to check their status.

"There is likely to be people who fall through the cracks," said the director of Medicaid at Kaiser Family Foundation, Robin Rudowitz.

The legislation doesn't revert all healthcare laws back to pre-COVID standards. Children in low-income households are still required to be kept on Medicaid for at least a year after they’ve enrolled.

The spending package also maintains the telehealth flexibilities that the pandemic ushered in, allowing healthcare facilities around the country to offer a greater number of services over the phone or computer.

These telehealth flexibilities will stay in place until at least the end of 2024, allowing for congress to study the program for longer, assess the levels of fraud, and determine its long term future.

"We can get some more time to assess where the benefits are with telehealth," said Andrew Hu of the Bipartisan Policy Center.