Background: Resuming public health care program renewals
How to maintain coverage for Minnesotans when federal continuous coverage requirements end
Coverage during the pandemic
Like all states, Minnesota has maintained health care coverage for its Medicaid enrollees during the COVID-19 pandemic. Since March 2020, Minnesotans who newly gained eligibility or already had eligibility for Medicaid (called Medical Assistance in Minnesota) or MinnesotaCare have remained enrolled in the coverage regardless of most changes in their lives that previously would have affected their coverage.
Continuous coverage helped Minnesotans access care during a global pandemic and maintained high insurance coverage rates in the state. It also allowed the state to receive billions in additional federal funding under the Families First Coronavirus Response Act, the first major federal stimulus package passed by Congress. Those federal funds were used during the public health emergency to help pay for health care services, make COVID-19 testing and treatment accessible at no cost to Minnesotans, and help support the direct care workforce, however the majority went into the state’s general fund.
Growth of enrollment
With these continuous coverage provisions in place, enrollment in Medical Assistance (Minnesota’s Medicaid program) and MinnesotaCare has grown by more than 360,000 people, or greater than 30%, to more than 1.5 million Minnesotans. One in four residents living in the state now get their health care coverage through these public health care programs.
Congress passed legislation requiring states to return to standard Medicaid eligibility procedures, which includes an annual eligibility review through a renewal process, in spring 2023. That means that most of the 1.5 million Minnesotans enrolled in Medical Assistance and MinnesotaCare will need to have their eligibility for these programs reviewed through the renewal process. Given the caseload growth, this represents a significantly larger volume of work than has ever occurred in the state’s public health care programs history. Experts across the country agree that the resumption of these renewal processes will create the biggest challenge to health care coverage since implementation of the Affordable Care Act.
The Centers for Medicare & Medicaid Services (CMS) has issued federal guidance outlining the expectations that states take all possible actions to maintain coverage for eligible individuals when renewal processes resume. States must conduct full eligibility reviews for most Medicaid enrollees before terminating coverage.