Medicaid Eligibility Redeterminations: Keeping Our Community Covered

CareFirst BlueCross BlueShield (CareFirst) is a not-for-profit healthcare company committed to ensuring access to affordable, quality healthcare. As part of our mission, under the Charter of the nonprofit health service plan, we assist and support public and private initiatives for individuals without health insurance. We recently hosted a virtual event to discuss Medicaid Eligibility Redeterminations.

In March 2020, Congress passed a law prohibiting states from terminating any enrollee's Medicaid coverage due to loss of eligibility during the COVID-19 Federal Public Health Emergency (PHE). This resulted in Medicaid enrollment swelling to its largest-ever level and the uninsured rate dropping to its lowest level. To ensure these coverage gains are not erased when the PHE ends, partnership and collaboration between federal and state governments, Medicaid Managed Care Organizations (MCOs) and commercial health marketing insurers are necessary.

During our virtual event, a panel of industry experts addressed the following:

  • Expansions in Medicaid enrollment and correlating reduction in uninsured rates during the COVID-19 PHE
  • The eventual unwinding of the ban on redeterminations of Medicaid eligibility and what steps should be taken to prepare for the resumption of eligibility redeterminations
  • How states, MCOs and commercial market insurers can partner to minimize disruption for people no longer eligible for Medicaid and ensure continuity of care when the PHE ends
  • Actionable steps for those who cycle off Medicaid when redeterminations resume to prevent them from becoming uninsured

The event was moderated by Wanda Oneferu-Bey, Executive Vice President of the Government Programs Division, CareFirst, moderated the event. Our distinguished panel included the following:

  • Debbie Ruppert, Executive Director of the Office of Eligibility Services, Maryland Department of Health and Mental Hygiene
  • Jennifer Krupp, MBA, MPH, PMP, Lean Sigma Six Black Belt (ICBB), Deputy Director of Outreach and Enrollment, Virginia Health Benefit Exchange (HBE), a division in the State Corporation Commission
  • Randy Pate, MPH, JD, former Deputy Director and Administrator for the Center for Consumer Information and Insurance Oversight (CCIIO) at the Center for Medicare & Medicaid Services (CMS)

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