March 9, 2023

The Medicaid and CHIP (Children’s Health Insurance Program) Payment and Access Commission (MACPAC) held a public meeting March 2, during which commissioners discussed the end of the federal government’s declared COVID-19 public health emergency (PHE). MACPAC, a nonpartisan legislative branch agency, provides policy and data analysis and makes recommendations to Congress, the secretary of the U.S. Department of Health and Human Services and the states.

The Centers for Medicare and Medicaid Services (CMS) and the states have been making preparations to unwind the continuous Medicaid coverage requirements when the PHE ends May 11. The Consolidated Appropriations Act of 2023 ends the continuous coverage requirement on March 31, which means states will have 14 months to complete all pending actions and 12 months to initiate renewals. Commissioners discussed concerns with states’ ability to contact and follow up with beneficiaries.

Commissioners revisited recommendations for countercyclical disproportionate share hospital (DSH) allotments. Medicaid DSH payments offset hospital uncompensated care costs for Medicaid-enrolled and uninsured patients. During economic recessions, Medicaid enrollment and the number of people who are uninsured increases. It was agreed upon at a past meeting that a countercyclical policy should be implemented during future economic recessions. The commission discussed the additional analyses provided by staff and voted to make this policy permanent in their recommendations to Congress, which will be finalized during the April meeting.

If you have questions or would like additional information, contact Kimberly Greck, American College of Radiology® Senior Economic Policy Analyst.


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