Axios Pro: Health Care Policy

November 14, 2022

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🚨 1 big scoop: Medicaid emergency coverage in play

Illustration of the U.S. Capitol building with a caduceus on top.

Illustration: Shoshana Gordon/Axios

There are discussions of an earlier rollback of some of the Medicaid continuous coverage provisions from the COVID-19 public health emergency (PHE) to help pay for priorities in the end-of-year package, congressional aides tell Peter.

  • A congressional GOP aide said Democrats had treated the idea as a "non-starter" in negotiations on previous packages, but it is now "in play."

Why it matters: The move could free up more money, but is also controversial given worries among Democrats that it could force some people to lose their coverage.

How it works: The Congressional Budget Office assumes the PHE and the associated ban on kicking people off Medicaid won't end until July.

  • So if Congress allowed states to even partially begin removing some people before then, once they're determined to be no longer eligible, CBO would score it as savings.

Between the lines: Some lobbyists following the process say this would mostly just be a budget gimmick.

  • That is, Congress would set any changes to kick in sometime next year, and the administration might end the PHE before then anyway, in which case the changes would be scored as savings now but would end up being moot.
  • However, some Democrats are worried that the move would tie the hands of the administration and make it harder to pull off the delicate task of unwinding the PHE without lots of people losing coverage.
  • "This may be a budget score gimmick for Republicans, but for Democrats, there’s real concern that people will lose coverage," said a House Democratic aide.

The bottom line: Even though the idea of using this as a "payfor" is coming more from the Republican side, all Democrats are not fully slamming the door, given that the move could free up important funding for other lame-duck priorities.

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