In a bid to address the alarming rates of children dropped from Medicaid, the U.S. Department of Health and Human Services (HHS) has called upon the governors of nine states — Arkansas, Florida, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota, and Texas — to implement federal rules aimed at facilitating the reinstatement of families' healthcare coverage. HHS Secretary Xavier Becerra outlined these measures in letters sent on Monday, pressing the states to adopt more than 400 available options provided by the Centers for Medicare and Medicaid Services (CMS).

One of the key options presented by HHS is the utilization of existing enrollee information to automatically renew coverage, mitigating administrative burdens and ensuring continuous access to healthcare services. Additionally, HHS released new guidelines for states, offering an extended timeframe of 12 months for children to enroll in Medicaid until 2024, as informed by CMS Administrator Chiquita Brooks-LaSure during a press briefing.

Alongside these recommendations, Secretary Becerra also urged the states to eliminate barriers to Children's Health Insurance Program (CHIP) enrollment for children who are no longer eligible for Medicaid. Furthermore, he called for the reduction of call center waiting times for families and encouraged the expansion of Medicaid programs in states where this action has not yet been taken.

Becerra emphasized the importance of comprehensive health coverage for all children, underscoring the urgency of preventing coverage losses due to bureaucratic hurdles or avoidable reasons, particularly as Medicaid's continuous enrollment provision during the COVID-19 public health emergency is being unwound. According to HHS, the nine states in question are responsible for 60 percent of children's coverage losses between March and September.

Highlighting the significance of state decisions, CMS Deputy Administrator Daniel Tsai asserted that states that have embraced the numerous policy flexibilities offered by CMS have been more successful in safeguarding children's coverage.

New data from HHS reveals that the 10 states that have not expanded Medicaid — Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming — have experienced more disenrollments among children compared to states that have expanded Medicaid. This disparity can partly be attributed to expansion states being more proactive in adopting CMS flexibilities compared to non-expansion states.

Following the conclusion of the public health emergency in May, states were required to conduct eligibility reviews of Medicaid enrollees. This subsequent unwinding process resulted in nearly 3 million children, as of now, losing their coverage, according to the Georgetown University Center for Children and Families. In August, HHS sent letters to all states warning them about potential non-compliance with federal requirements, citing long wait times at call centers, a high number of disenrollments stemming from paperwork issues, and a slow application process.

In September, CMS acknowledged that half a million individuals, including children, who had lost coverage were mistakenly disenrolled due to errors on the part of the states. States were promptly instructed to pause disenrollments, reinstate affected individuals, and mitigate the risk of losing federal funding.

Responses from the nine states addressed by HHS have not been immediately received at the time of reporting. The urgency to rectify the issue of dropped Medicaid coverage for children remains a priority, necessitating swift action from both the states in question and federal entities to ensure all eligible children receive the essential healthcare coverage they deserve.