March 05,2024

Wyden and Pallone Urge CMS to Ensure All States Come into Full Compliance with Medicaid and CHIP Eligibility Requirements

Democratic Health Leaders Request States Commit to Long-Term, Public Compliance Plans

Washington, D.C. – Senate Finance Committee Chairman Ron Wyden (D-OR) and House Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ)  wrote to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure today to urge the agency to require states to commit to a concrete plan for coming into full compliance with Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment requirements going forward.

“The end of COVID-19 pandemic protections unveiled long-standing problems with many states’ eligibility and enrollment systems and operations that are unnecessarily leaving millions of low-income Americans—including children—without health coverage. It does not have to be this way—states are able to make choices regarding their operations and policies—and these choices have real consequences for Americans’ health and wellbeing,” the Democratic health leaders wrote. “We commend CMS for its ongoing work to promote continuity of coverage for people enrolled in Medicaid and CHIP. We also believe it is imperative that CMS acts not only to mitigate and correct the inappropriate coverage losses that are happening now, but also to ensure states make permanent fixes to their eligibility and enrollment systems that are failing so many families and children.”

As COVID-19 pandemic eligibility and enrollment protections came to an end, Congress gave states the necessary tools and resources to return to normal eligibility and enrollment operations. However, this process, known as “unwinding,” revealed that many states’ systems are not operating properly—leaving tens of millions of low-income Americans’ health coverage hanging in the balance. As a result, Americans already suffering catastrophic consequences, including missed cancer diagnoses and people with chronic illnesses, are going without needed lifesaving medications. Wyden and Pallone expressed concern in their letter that states’ inadequate systems will continue to harm Americans’ access to health care for years to come if not corrected.

“We also remain deeply concerned that, without further and expedient action, these state failings will continue well into the future,” Wyden and Pallone continued. “We now urge CMS to expeditiously address failures in state systems by requiring all states to commit to a specific and detailed plan to adopt sustainable, long-term systems fixes. Further, to promote transparency and state accountability for identified gaps and adherence with their plans for fixing them, these plans should be made public, and CMS should continue to require states to submit and make public states’ eligibility and enrollment operations data.”

Read the full letter HERE.