Infectious Disease

AMA adopts policies to help limit insurance loss

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Since the COVID-19 pandemic began, the world has hoped for an end to the public health emergency — but that distinction could also mean millions losing their insurance coverage.

Patients enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) have been protected by a requirement in which states must continue to provide coverage to these patients during the public health emergency in return for “a temporary increase in federal matching funds,” according to an AMA press release. But once the public health emergency expires, states have to redetermine the eligibility status of every Medicaid and CHIP patient, and many are at risk for losing their coverage.

Source: Adobe Stock.

“Throughout the public health emergency, Medicaid and CHIP have provided health coverage and care to more than 80 million people, including individuals affected by COVID-19 and those who experienced pandemic-related job losses. Because of federal support, the uninsured rate has remained steady even in the face of a pandemic,” Willie Underwood III, MD, MSc, MPHto AMA trustee, said in the release.

In response to the concerns, AMA endorsed policies at its House of Delegates meeting that aim to help patients maintain their insurance coverage after the public health emergency expires.

“We must be vigilant that our patients don’t lose their coverage just because of a change in federal designation of a public health emergency. They are counting on us to find ways to stay covered,” Underwood said in the release.

The policies “aim to make sure that individuals who remain eligible for Medicaid/CHIP retain their coverage and those no longer eligible successfully transition to alternate coverage for which they are eligible” as states prepare for the end of the public health emergency and the “massive undertaking” that will follow, AMA said.

It is “critical for policymakers to address health equity implications” because people of color — who make up more than half of Medicaid patients — will be significantly impacted, according to the release.

The AMA recommends the following to prevent loss of coverage:

  • streamlining enrollment and renewal;
  • investing in outreach and enrollment assistance;
  • adopting continuous eligibility;
  • encourage auto-enrollment;
  • encourage automatic transition; other
  • providing monitoring and oversight.

“These policies are part of a longstanding AMA goal to expand access to and choice of affordable, quality health insurance coverage. We are concerned that once the public health emergency ends, state eligibility redeterminations will result in more patients becoming uninsured,” Underwood said in the release. “We hope that states will employ strategies to help Medicaid-eligible patients keep their coverage and transition those no longer eligible into other affordable health plans.”

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