CMS Offers Special Marketplace Enrollment during Medicaid, CHIP Unwinding

April 01, 2024

The Biden administration unveiled new strategies to help people maintain coverage following the return of Medicaid and Children’s Health Insurance Program (CHIP) eligibility renewals.

Last week, federal officials announced a special enrollment period for people who are no longer eligible for Medicaid or CHIP to transition to marketplace coverage and a proposed rule to simplify the enrollment and renewal processes. The “unwinding special enrollment period” will be extended from July 31, 2024 to November 30, 2024 for people who no longer qualify for Medicaid and CHIP, federal officials said.

“We are helping those who will now qualify for marketplace coverage obtain it,” said Health and Human Services Secretary Xavier Becerra. “We will continue to monitor the renewal process and make sure federal requirements are being followed.”

Coverage renewals began last spring after a pause during the COVID-19 pandemic. CMS encouraged states like Pennsylvania that run their own insurance marketplaces to follow suit with the special enrollment period. In Pennsylvania, you are eligible to enroll in marketplace coverage if you experience a Qualifying Life Event (QLE), such as loss of Medicaid coverage.

Additionally, CMS released a final rule last week that standardizes enrollment and renewal processes nationwide and seeks to make it easier for eligible children and adults to stay covered by: 

• Eliminating annual and lifetime limits on children’s coverage in CHIP.
• Ending the practice of locking children out of CHIP coverage if a family is unable to pay premiums.
• Eliminating waiting periods for CHIP coverage.
• Addressing the transfer process for children from Medicaid to CHIP when a family’s income rises.
• Requiring states to provide all individuals with at least 15 days to provide any additional information when applying for the first time and 30 days to return documentation when renewing coverage.
• Prohibiting states from conducting renewals more frequently than every 12 months and requiring in-person interviews for older adults and those with disabilities.

“Protecting and strengthening access to health coverage in Medicaid, CHIP, and the marketplaces is a top priority,” CMS Administrator Chiquita Brooks-LaSure said in a statement.

Guidance on unwinding processes and tools for states reinforcing important federal renewal requirements are available online.

CMS last week also rolled out new rules for Short-Term, Limited-Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage, or “Junk Insurance.” Be on the lookout for additional details in HAP’s publications.