Mar 28, 2024 - Health

New Medicaid rule aims to simplify enrollment

Illustration of a wall of cracks with bandaid-shaped red crosses

Illustration: Sarah Grillo/Axios

Enrolling in Medicaid and staying on the program's rolls is about to get easier under a streamlined process the Biden administration finalized on Wednesday.

Why it matters: The changes are expected to increase Medicaid enrollment by about 1.3 million people when fully implemented in 2028.

  • Total Medicaid spending will rise $59 billion — $36.2 billion of which would come from the federal government — from the changes.

Zoom out: Biden administration officials say removing barriers to Medicaid coverage will ultimately reduce states' administrative costs and keep patients healthier.

How it works: Applying for Medicaid will involve less paperwork, and most enrollees who are eligible because they're 65 or older or disabled will now get 12 months of uninterrupted coverage without the state initiating a renewal.

  • The rules also establish guidelines for states to check available data before cutting off an enrollee's coverage. And for the first time since 1986, the Centers for Medicare and Medicaid Services is updating record-keeping requirements for state Medicaid agencies.
  • The policies will begin to take effect in early June.

The rule also makes it easier for kids to benefit from Medicaid's sister program, the Children's Health Insurance Program.

  • States will no longer have the option of imposing a waiting period before kids can enroll in CHIP or placing annual and lifetime limits on CHIP benefits.

What they're saying: "I am so pleased to see that CHIP waiting periods — a forced period of uninsurance that doesn't exist elsewhere in our insurance system — are finally gone," Joan Alker, executive director of the Georgetown Center for Children and Families, said in a statement.

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