Medicaid’s Day of Reckoning: Ending the Public Health Emergency

On January 27, 2020, the federal government authorized a Public Health Emergency Declaration (PHE) relating to the Covid-19 Pandemic.  This declaration implemented a “Continuous Coverage” requirement for Medicaid recipients, meaning Indiana cannot remove folks from Medicaid.

As of June 1, 2022, the Indiana FSSA office continues to abide by this requirement and is not terminating Medicaid, lessening benefits, or implementing transfer penalties, even if a Medicaid recipient is over resources.   This protection has ensured thousands of elderly and disabled Hoosiers have continued to receive vital care during the Pandemic.  However, as all good things must come to an end, Medicaid will soon begin the process of “Unwinding” the PHE and resume terminating Medicaid coverage and instituting transfer penalties.

The current extension of the PHE runs through July 15, 2022, meaning the soonest Indiana can begin disenrollments is August 1, 2022.  However, the Biden Administration has promised to provide a sixty (60) day notice of their intention to end the PHE.  With no notice being provided by May 16, 2022 (and an assumption of a 90-day extension), that pushes the Unwinding date to November 1, 2022.  With an election set to occur within a week of that date, the Biden Administration is likely to face great pressure for another extension.

The Medicaid Continuous Coverage Requirement has allowed numerous Hoosiers to continue their coverage even if they are over resources or have gifted assets typically subject to a penalty period.  Once the PHE as been officially declared over, the “Day of Reckoning” for Medicaid recipients will begin.

Indiana has not formally announced their process for Unwinding the Continuous Coverage, but we do anticipate that the implementation of penalties and disenrollments beginning relatively quickly.  If a transfer of assets would trigger a penalty period that extends past the date of the Unwinding, the State may implement the remainder of the penalty after the PHE has ended.   We will be sure to provide an update once Indiana releases official guidelines.

Indiana will have a daunting task of reassessing the eligibility status of Medicaid recipients, meaning there is likely to be a great deal of confusion and undue hardship once the PHE has ended.  We are more than happy to meet to ensure there are no disruptions to your loved one’s care as our “New Normal” once again changes.

Thank you,
Michael J. Huffman
June 2022