Looming government shutdown could disrupt Medicaid redeterminations

A government shutdown could cause hiccups in the unwinding of Medicaid continuous coverage requirements. 

In a Sept. 15 news release, the National Association of Medicaid Directors said consistent federal appropriations is "critical" during the Medicaid redeterminations process. 

"Lapses in appropriations for CMS could disrupt this work, causing delays that incur additional costs and obstacles for both people served by Medicaid and the state and territorial agencies administering the program," the association said in its statement. 

In a blog post published Sept. 25, researchers at Georgetown University's McCourt School of Public Policy in Washington, D.C., wrote that CMS employees responsible for making Medicaid and CHIP payments to states will work through a shutdown, and states will continue to receive federal funds. 

Though essential functions will continue, it could be difficult for states to get technical assistance from CMS during the shutdown, and the agency could have limited oversight of the process. 

"State eligibility workers won't be impacted, so renewals (and any required reinstatements) will continue to proceed as scheduled during a government shutdown. But CMS will be operating with a very thin staff and will likely be seriously impaired in keeping up with proper oversight or enforcement actions related to unwinding once the shutdown takes effect," the researchers wrote. 

CMS has intervened in the unwinding process to stop improper disenrollments. On Sept. 21, the agency said it paused procedural disenrollments in 30 states reporting issues with their automatic renewal system. 

As of Sept. 22, over 7.4 million people have been disenrolled from Medicaid through the redeterminations process, according to KFF. 

Around 42 percent of HHS' staff will be furloughed in the event of a shutdown, according to the agency's contingency plans. Congress faces an Oct. 1 deadline to reach an agreement to avoid a shutdown. 

CMS has enough funding to keep Medicaid running for three months in the event of a shutdown, according to The Washington Post. The most recent government shutdown, in 2018 and early 2019, lasted 34 days. 

"The effects in healthcare, at least systemwide, are maybe less than in other areas," Larry Levitt, executive vice president for health policy at KFF, told The Washington Post. "But there are many programs where individual clinics or mental health programs depend on federal grants or funding, which could stop particularly with an extended shutdown." 

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