Medicaid Redetermination—How Employers Can Prepare

Up to 18 million people may no longer be eligible for Medicaid coverage now that states are required to resume annual Medicaid renewals, following a “break” and relaxed social service benefits rules during the pandemic. Because The Families First Coronavirus Response Act (FFCRA) declared a public health emergency, states were prohibited from disenrolling Medicaid recipients.

This is no longer the case — and those impacted by disenrollment will likely look toward employer-sponsored plans for coverage.

A provision of the federal Consolidated Appropriates Act of 2023 separates the public health emergency from the Medicaid enrollment process. This means states can return to their previous Medicaid redetermination processes.

As employers, you play an important role in advocating for health care coverage and can serve as a valuable resource for team members who may lose their state benefit. First, work with your benefits consultant to understand the potential impact of Medicaid recipients joining your plan. How will this impact claims, cost and coverage. A proactive communication and support strategy will help you maintain compliance while delivering important information to employees during a stressful time.

Help employees understand their options. Here are some ways you can prepare for potential changes and serve as an advocate for your people.

• Explain the details. Communicate what redetermination means and what employees can expect.
• Consult with your carrier. Your benefits consultant is a ready resource. Find out how redetermination will roll out in states during 2023 and what this means for your business.
• Prepare for special enrollment. Employees that experience a loss of Medicaid benefits can take advantage of a 60-day Special Enrollment Period when those who are eligible can join your company plan.

How can we help? Contact your TFG Employee Benefits consultant today.

Additional information can be found here.