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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Rockefeller Proposes 12-Month Continuous Enrollment in Medicaid/CHIP

February 5, 2014 | Medicaid | Comments
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On February 3rd—the fifth anniversary of the Children’s Health Insurance Program Reauthorization Act—Senator Jay Rockefeller of West Virginia introduced a bill to ensure that Medicaid and CHIP beneficiaries remain continuously enrolled for 12-month periods. The bill would ensure that individuals do not have to undergo frequent eligibility redeterminations, which can result in “churning” of individuals in and out of coverage.

Currently, each state decides the length of Medicaid and CHIP eligibility and the frequency of eligibility redeterminations. Under the Medicaid and CHIP Continuous Quality Act of 2014 (S. 1980), all states would be required to provide twelve-month continuous enrollment for these beneficiaries.

The National Council strongly supports legislative efforts to reduce the impact of churning on enrollees and their families. Frequent eligibility redeterminations can cause even eligible individuals to lose their coverage, often due to small fluctuations in income or changes in their living situation. Individuals with mental illness and substance use disorders may be at high risk for losing coverage even when remaining eligible.

In addition to establishing twelve month continuous enrollment, Senator Rockefeller’s bill would:

  • Direct the Secretary of Health and Human Services to establish standardized quality measures of the care provided to Medicaid and CHIP beneficiaries;
  • Provide financial incentives to states to take steps to reduce “churn” in their Medicaid and CHIP programs; and
  • Provide financial incentives to states to improve the quality of care across their Medicaid and CHIP programs.

Notably, this bill creates a mechanism to measure and evaluate the quality of care that Medicaid and CHIP beneficiaries receive, no matter how the care is delivered—through a managed care plan, through primary care case management, or through fee-for-service. This will allow for policymakers and others to make decisions based on a full spectrum of information about the quality of care delivered through their Medicaid program.