Medicaid unwinding is CMS agency’s ‘biggest challenge’

WASHINGTON – The Medicaid unwinding that is scheduled to begin in weeks “is our agency’s biggest challenge,” said the administrator for the Centers for Medicare and Medicaid Services.

Chiquita Brooks-LaSure, CMS administrator, gave a run-down on her agency’s top priorities during America’s Health Insurance Plans’ 2023 Medicare, Medicaid, Duals and Commercial Markets Forum on Tuesday.

“It’s not only the Medicaid unwinding, but also transitioning from some of the flexibilities that people have become accustomed to during the public health emergency,” she said. “Congress has extended some of them, such as expanded tax credits to buy health insurance, but some are going away with the end of the PHE.”

Seeking a 'smooth transition'

Brooks-LaSure said one of CMS’s top priorities “is to ensure a smooth transition from COVID-19 waivers and flexibilities, including continuous enrollment.”

A record number of Americans currently have health coverage, and Brooks-LaSure said CMS wants to help them keep that coverage.

With expanded tax credits included in the Inflation Reduction Act, four out of five people who sought coverage under the Affordable Care Act exchanges found coverage for $10 per month or less, Brooks-LaSure said.

“We have made unprecedented efforts to invest in our enrollment enhancement network,” she said. “We looked at communities with high uninsured rates and helped to get more people in those communities enrolled.”

A record 16 million Americans obtained ACA coverage during the most recent open enrollment period.

'Affordability and accessibility' sought

“This year’s marketplace open enrollment showed us what works – great affordability and accessibility,” Brooks-LaSure said.

She said one of CMS’s priorities is “to increase access to care for those enrolled in Medicaid and CHIP.”

“Medicaid and CHIP are critical to our work to increase health equity,” she said.

This spring, CMS will release a proposed rule for those who are enrolled in Medicaid and managed care, she said. The aim of that proposed rule is to enhance care for Medicaid enrollees, “to ensure people can see the providers they need.”

She said her agency continues to implement the No Surprises Act, which was passed in November and prevents consumers from receiving surprise bills from health care providers.

Brooks-LaSure said part of CMS’s mission “is to advance equity to the people we serve.”

“We are paying attention to how all our policies impact equity. We are committed to supporting doctors, nurses and health care providers who care for the people we serve.”

She said part of the CMS strategic plan is advancing care in rural, tribal and geographically isolated communities. “It’s really eye opening to see the fragility that exists in some parts of the country,” she said. For example, she visited a hospital in Colorado where employees told her the road leading to the hospital is not drivable an average of once every three days because of weather.

“What we’ve been trying to do is to think about what we can do across our programs to improve access,” she said. “Medicaid a big provider of rural health. We are looking at in our marketplace plans, essential community providers and making sure they are part of the networks.”

CMS does not deliver health care, so health care must be delivered in partnership with the private sector, Brooks-LaSure said.

“The real lesson we’ve learned in the past couple of years is, what does it mean to our country if we don’t address the health disparities that exist,” she said. “The good part of this lesson is, we must work together.”

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].