Biden-Harris administration proposes to make health care enrollment easier for millions of Americans – InsuranceNewsNet

Baltimore, Maryland, September 1st — The US Department of Health and Social Services Centers for Medicare and Medicaid Services issued the following press release on August 31, 2022:

In a historic effort to improve access to health care for millions of Americans, the Biden-Harris Administration proposed a new rule to overhaul Medicaid enrollment processes, the Children’s Health Insurance Program (CHIP) and Basic Health Programs (BHP), and eliminate arbitrary coverage caps for CHIP children. In a notice of proposed rulemaking (NPRM), the Department of Health and Social Services (HHS), through the Medicare and Medicaid Service Centers (CMS), is working to cut red tape and simplify the application and verification processes to enable children, seniors, and low-income people with Medicaid and CHIP coverage to enroll and maintain vital health insurance. This proposed rule follows of President Biden executive orders in April 2022 and January 2021 directing federal agencies to take action to expand affordable, quality health coverage, including strengthening Medicaid and the Affordable Care Act.

Under the Biden-Harris Administration, thanks to the US bailout and other administration efforts, more Americans than ever before have health insurance coverage. The rule proposed today will build on these efforts and support of President Biden calls for strengthening Medicaid and access to affordable, high-quality health coverage.

“Medicaid and CHIP provide essential health care to millions of families across the country, and we make it easier to enroll children and others in health insurance and maintain coverage,” the secretary said. of the HHS. Xavier Becerra. “With these actions, we are delivering on our promise to make high-quality health care more accessible and affordable for all Americans.”

“CMS is taking action today to protect and strengthen health care coverage for the more than 88 million people enrolled in Medicaid, CHIP and the Basic Health Program,” the CMS Administrator said. Chiquita Brooks-LaSure said. “This proposed rule will ensure that these individuals and families, often from underserved communities, can access the health care and coverage to which they are entitled – a fundamental principle of health equity. Further, This proposed rule will help more people pay their health insurance premiums by making it easier for them to enroll in Medicare savings programs.”

This rule, if finalized, would standardize common sense eligibility and enrollment policies, such as limiting renewals to once every 12 months, giving applicants 30 days to respond to requests for information, requiring pre-populated renewal forms, and establishing clear and consistent renewal processes across all states.

Medicaid and CHIP are essential sources of health insurance for families across the country. Medicaid is the largest health coverage program in the world. WE, covering nearly one in four Americans and offering solid benefits with little or no out-of-pocket. Together, Medicaid and CHIP provide 51% of our country’s children and youth – more than 40 million children – with access to affordable, quality health care. However, enrollment in these programs can be compromised due to cumbersome application or renewal processes and lack of uniformity in states across the country. This NPRM addresses these concerns and includes a series of proposed options to make it easier to access and maintain healthcare coverage.

In a major program transformation and historic victory for American families, the Biden-Harris Administration proposes to end lifetime benefit limits in CHIP and allow children to immediately enroll in coverage by eliminating waiting periods before enrollment, consistent with nearly all other health coverage. The proposed rule would also allow states to transfer children’s eligibility directly from Medicaid to CHIP when a family’s income increases, preventing unnecessary redetermination processes from causing interruptions in coverage.

The NPRM proposes simplifications that would increase the enrollment and retention of people aged 65 and over, as well as those who are blind or disabled. The proposed rule, if finalized, would streamline the application process for these programs by removing unnecessary administrative hurdles for people who do not have — but are eligible for — Medicaid, CHIP or BHP coverage. These people are often eligible for Medicaid but are not yet enrolled or have difficulty staying enrolled due to systemic barriers, potentially missing coverage and life-saving care through cumbersome processes.

The proposed rule also includes policies that would improve access to programs that help make health coverage more affordable for seniors and people with disabilities. It offers ways to simplify enrollment in Medicare savings programs, which allow Medicaid to pay Medicare premiums or share costs for low-income Medicare beneficiaries. The proposed rule would also allow automatic enrollment in Medicare savings programs for certain people receiving the Social Security Administration Additional security income – a key objective to streamline connections to take care of those who need it most.

A recent study estimated that only about half of eligible low-income people enrolled in Medicare were also enrolled in Medicare savings programs. This proposed rule would automatically consider seniors for enrollment in Medicare savings programs when applying for low-income subsidies to help pay for Medicare Part D coverage, reducing time and expense charges. eliminating the need to complete multiple applications.

Finally, proper documentation is essential to enable proper oversight, identify errors in state policies and operations, and reduce inconsistent and outdated practices among states that contribute to improper payments. This proposed rule would update and standardize record-keeping requirements for states, which would help close the gaps in outdated state record-keeping systems and improve program integrity.

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