Due to the COVID-19 public health emergency, the Families First Coronavirus Response Act was passed in March 2020. This bill required states to halt their standard eligibility checks on current and new Medicaid and CHIP users, which could often result in denials of coverage based on income levels, missing paperwork, and other factors. For taking on this high additional cost, the federal government provided a temporary 6.2 percent increase to the states in the federal portion of Medicaid and CHIP funding.

With the pandemic winding down, the federal government prepares to shut off the flow of this additional funding. States will once again be able to perform eligibility checks on their current and new Medicaid and CHIP users, which could result in a loss of health insurance for as many as 15 million children and adults across the country.

Enrollment in CHIP and Medicaid increased 11.4 percent since the pandemic began in February 2020, skyrocketing the number of users to a record 83.6 million in July 2021. Now, one in four Americans and half of all American children are covered by Medicaid or CHIP, a plan generally reserved for only the lowest income people.

Concerns about the upcoming shift are already resulting in long phone wait times in many states, such as Texas, which despite growing by 1 million Medicaid enrollees, has faced budget and staff cuts for their program. Due to these types of issues, the Centers for Medicare and Medicaid Services (CMS) has extended the period for eligibility and enrollment checks to take place up to 14 months.

Many children who lose Medicaid coverage may now be eligible for CHIP, which has higher income thresholds. However, parents will now need to complete the proper paperwork and eligibility checks to enroll their kids, which is often a complex task requiring assistance from already busy CHIP staffers.

Families who lose Medicaid or CHIP coverage likely qualify for subsidized health insurance premiums through an Affordable Care Act (Obamacare) marketplace, such as TrueCoverage, which offers more than 50,000 health insurance plan options across the U.S. 70 percent of TrueCoverage applicants may qualify for FREE quality health insurance! And the remainder typically qualify for BIG monthly premium discounts!

Loss of insurance coverage from Medicaid or CHIP is known as a qualifying event, opening the Special Enrollment Period, allowing enrollment in an ACA health insurance plan outside of the typical annual Open Enrollment period.

Special Enrollment Period (SEP) qualifiers include:

  • Loss of Coverage
    • Losing eligibility for Medicare, Medicaid, or CHIP
    • Loss of job
      • ACA coverage is often more affordable than COBRA!
    • Loss of health insurance coverage through school
    • Becoming age 26 and losing parental coverage
    • Health insurance enrollment or plan error
  • Change in Household
    • Marriage or divorce
    • Birth or adoption of a new baby
    • Death in the family
    • Separating from a domestic abuse partner
    • Becoming a U.S. Citizen
  • Housing Changes
    • Moving to a different ZIP code or county
    • A student moving to or from where they attend school
    • A seasonal worker moving to or from where they work
    • Moving to or from a shelter or transitional housing
    • Being a victim of a natural disaster
    • Being released from incarceration (jail or prison)
    • AmeriCorps members starting or ending their service
  • Low-Income Families – Annual Income Threshold
    • Single Household – $19320 annually
    • Household of Two – $26130 annually
    • Household of Three – $32940 annually
    • Household of Four – $39750 annually
    • Household of Five – $46560 annually

Visit TrueCoverage.com to see what you may qualify for or call 1-888-611-3705 to speak to a TrueCoverage agent to discuss your options.

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