CMS extends Medicaid waivers to 2025

CMS will extend flexibilities designed to help states keep more eligible individuals enrolled in Medicaid through June 2025. 

The waivers, previously set to expire at the end of 2024, will be extended for six more months, Daniel Tsai, deputy CMS administrator and director of the Center for Medicaid and CHIP services, wrote in a May 9 memo to states.  

Nearly all states were expected to complete the unwinding process by June 2024, Mr. Tsai wrote, but because several states took extension waivers from CMS, several states will continue renewals past June. 

States began the process of redetermining the eligibility of Medicaid recipients for the first time since 2020 in April 2023, after continuous eligibility requirements in place during the COVID-19 pandemic expired. As of May 10, 21.9 million people have been disenrolled from Medicaid since April 2023, according to KFF. 

The number of Medicaid beneficiaries disenrolled from the program has exceeded HHS' estimates that 15 million people would lose coverage.

Of those disenrolled, 69% had their coverage terminated for procedural reasons, such as failing to return required paperwork, rather than being determined ineligible for the program, according to KFF

CMS has approved 398 total waivers across 52 states designed to increase the number of ex parte, or automatic, renewals, facilitate renewals for disenrolled members, and other uses. Uptake varies by state, with South Dakota requesting just one waiver, and Indiana and Tennessee requesting 15 each. 

States that obtained few waivers from CMS to ease the unwinding process and completed the process in less than 12 months are likely to have higher rates of disenrollments, according to a report from the Robert Wood Johnson Foundation and the Urban Institute. 

According to KFF, states still need to determine eligibility for 24 million more Medicaid beneficiaries. 

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