CMS Solicits Input on Potential Medicaid and CHIP Reforms Around Eligibility, Enrollment and Access

Leveraging Section 1902(e)(14) Waiver Authority Amid Unwinding

The Medicaid continuous coverage requirement enacted by the Families First Coronavirus Response Act prohibits states from disenrolling individuals from Medicaid for the duration of the public health emergency (PHE) as a condition of accessing enhanced federal Medicaid funding. When the PHE ends, Medicaid and Children’s Health Insurance Program (CHIP) agencies will be charged with facilitating smooth transitions of coverage to the Marketplace to ensure eligible individuals retain access to care and to protect against disproportionate coverage loss among people of color.




To support states in their efforts to successfully “unwind” from the Medicaid continuous coverage requirement and resume normal eligibility and enrollment operations, the Centers for Medicare & Medicaid Services (CMS) has made available a number of time-limited 1902(e)(14) ) waiver authorities. Section 1902(e)(14)(A) of the Social Security Act allows for waivers “as are necessary to ensure that states establish income and eligibility determination systems that protect beneficiaries.” The unwinding-related Section 1902(e)(14) strategies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges.


In “Leveraging Section 1902(e)(14) Waiver Authority Amid Unwinding,” an expert perspective prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through the Section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources.


To real the full expert perspective, click here.



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