New Federal Policies Help Eliminate Barriers to Medicaid and CHIP Access for Texans

The Centers for Medicare and Medicaid Services (CMS), Texas’ partner in administering Medicaid and Children’s Health Insurance Program (CHIP), released a Final Rule to better streamline the application, eligibility determination, enrollment, and renewal processes it regulates across states and public insurance coverage types. Overall, the goal of these policies is to reduce the “churn” of people moving on and off insurance coverage due to issues with paperwork, agency processes, and gaps in data-sharing. This rule is a collection of tweaks that will have enormous impacts on all Texans — even those who have other kinds of insurance.

Medicaid is a cooperative state and federal program, meaning CMS and the Texas Health and Human Services Commission (HHSC) set the policies for the program while the state and federal governments fund it. Though CHIP and Medicaid are separate programs in Texas, changes to CHIP policy also require cooperation between the states and federal government. In some cases, changes to federal policy — like this Final Rule — create options and flexibilities for states. Other times, CMS policy requires states to make changes.

A unique aspect of this Final Rule — and the basis for all of the policy changes in it — is a reminder that preserving the “integrity” of these programs does not just mean being vigilant about fraud and abuse; it means stewarding the program in a way that ensures people we know are eligible (or should know based on data we already have) are enrolled in and can keep their coverage.

This Final Rule requires that changes be made to the systems and processes states use to determine whether a person is eligible or not for Medicaid and CHIP. The highly anticipated — if belated — policy changes were strongly encouraged by Every Texan and our partners, and even largely supported by HHSC as well.

Source: New Federal Policies Help Eliminate Barriers to Medicaid and CHIP Access for Texans / Every Texan

Leave a Reply

Your email address will not be published. Required fields are marked *