Data and the End of the Public Health Emergency

• Helping those eligible to maintain some form of coverage at the end of the PHE is a priority for the Enrollment Coalition. We believe additional policies would be useful to states, plans, providers, consumers, and patients as we plan for the end of the PHE. For example, additional guidance could encourage states to:

  • modify requirements for in-person and phone interviews,

  • allow the state Medicaid agency to determine presumptive eligibility,

  • allow additional entities to be able to determine presumptive eligibility for certain vulnerable populations, and

  • accept self-attestations and conduct post-enrollment verification of specific eligibility requirements in a timely manner.

• Additionally, sample waivers and technical assistance for states could support increased adoption of strategies like Express Lane Eligibility, SNAP facilitated enrollment, and continuous eligibility.

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Autoenrollment

• Millions of Americans are eligible for subsidized health insurance but are not enrolled in coverage. People of color are disproportionately likely to fall into the enrollment gap, as are working-class families. The Enrollment Coalition believes that it must be a top policy priority to ensure that those who are eligible are enrolled and retained in coverage. Autoenrollment policies can bridge the persistent enrollment gap and promote equity and health for those needing care. The Coalition has developed a framework for an autoenrollment policy that supports the enrollment of eligible individuals and families, protects patient choice, and preserves program integrity. The Coalition’s framework for an autoenrollment policy can be found: here

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Telephone Consumer Protection Act

• When used to remind enrollees of renewal requirements and health care appointments, provide assistance with navigating plan benefits, and provide fundamental health education, text messaging can be an effective method of communication for individuals with Medicaid. Importantly, text messaging can reduce coverage churn in Medicaid. Culturally and linguistically appropriate text messaging can also reduce health disparities and improve health outcomes. The Enrollment Coalition believes health care entities should be able to contact consumers to support the consumer’s enrollment in health coverage, including critically important information on both coverage (such as when patients may be at risk of losing coverage), and medical care and health care services (such as immunization reminders).

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Health Equity

• Section 4302 of the Affordable Care Act added Section 3101 to the Public Health Service Act (PHSA) requiring “any federally conducted or supported health care or public health program” to collect and report data, to the extent practicable, on race, ethnicity, sex, primary language, and disability status. Section 3101 also instructs the Secretary of Health and Human Services to “analyze data collected under paragraph (a) to detect and monitor trends in health disparities.” However, this section also included subsection (h) which prevents the implementation of this provision unless Congress specifically appropriates funding for these activities. To date, Congress has not provided funding specifically for carrying out this provision and this provision has not been fully implemented. The Enrollment Coalition is seeking a legislative change to strike subsection (h) of Section 3101 of the PHSA to allow HHS to collect and analyze important data related to health disparities within health coverage programs.