While it hasn’t drawn much attention, there are currently two bills in the House and Senate, and respectively, that have the potential to greatly improve health coverage for millions of Americans. The Stabilize Medicaid and CHIP Coverage Act of 2019 would require “12-month continuous enrollment of individuals under the Medicaid program and Children’s Health Insurance Program”. Recognizing the importance of continuous healthcare coverage, especially for vulnerable populations like Medicaid and CHIP enrollees, URAC recently sent letters of support to the sponsors of this bill.
URAC is worried that millions of individuals that enroll in Medicaid and CHIP too often lose their coverage despite maintaining eligibility due to onerous government reporting requirements and often redundant paperwork. These bills would ensure that an individual that is deemed eligible for either program maintains that eligibility “through the end of the month in which the 12-month period ends”.
Interruptions in healthcare coverage can result in higher administrative costs for states, providers and health plans. In fact, many hospitals, physicians and health plans often hire staff who are solely focuses on eligibility verification and assistance. As such, streamlining eligibility reverification requirements would allow for more resources to be devoted to clinical care.
In fact, just last year the Center for Budget and Policy Priorities (CBPP) released a showing that proposed waivers to increase reporting requirements for Medicaid enrollees “will not only impede access to care, they will also increase uncompensated care, especially for hospitals”.
More importantly, patients may avoid seeking medical attention altogether during this coverage gap or even worse, wind up in the emergency room where they will almost certainly be subjected to unaffordable bills.
Given the increased focus on eliminating waste to make the healthcare system more efficient, allowing for continuous 12-month coverage for Medicaid and CHIP enrollees appears to be a step in the right direction. In my opinion, a value-based healthcare system should be focused on ensuring care continuity not reneging healthcare coverage due to cumbersome and unnecessary paperwork.
You can read URAC’s letter to Senator Sherrod Brown (D-OH), sponsor of S. 873 by clicking here.