Guidance on the End of Continuous Enrollment for Medicaid in SC
On April 1, 2023, the Medicaid Continuous Enrollment Provision of the Federal Public Health Emergency (PHE) ended, initiating the “Medicaid Unwinding” redetermination process over the next 12 months. The Department of Health and Human Services projects almost one-third of those predicted to lose eligibility will qualify for Marketplace premium tax credits. Among those individuals, over 60 percent are expected to be eligible for zero-premium Marketplace plans. Losing Medicaid or CHIP coverage is considered a Qualifying Life Event and will allow patients to enroll in a Marketplace plan outside of the usual open enrollment period as individuals lose their coverage.
Many newly uninsured individuals will likely qualify for ACA Marketplace plans – many at no cost to the insured. Hospitals have a unique opportunity to provide education to enrollment provisions in person and to make patients aware of resources available to them, such as:
- Suggestions for providers to participate in the unwinding process
- SCDHHS Member Fact Sheet
- SCDHHS Provider Fact Sheet
- SCDHHS Quick Tools Change of Address Forms
- CMS Unwinding Toolkit
- The South Carolina Department of Insurance listing of all Navigators available in South Carolina
- Healthcare.gov Special Enrollment Period
In addition to these planning and educational resources, our patients have access to two programs in South Carolina that can provide direct assistance obtaining coverage:
- SC Thrive provides help connecting individuals to various resources, including reapplying for SC Medicaid, and assisting in the Marketplace registration process. SC Thrive can be reached at contact@scthrive.org or (800) 726-8774. Their contact center is open 8:30 AM-5:00 PM, Monday-Friday.
- The Palmetto Project assists patients in either reapplying for Medicaid or determining eligibility for a Marketplace plan and assisting the patient in the registration process. The Charleston Palmetto Project office is available at (843) 577-4122 or by email at charleston@palmettoproject.org. The Columbia office is available at (803) 779-4875 or columbia@palmettoproject.org.
We encourage our members to make every effort possible to educate the newly uninsured of opportunities available to them in order to avoid a new surge in uninsured costs. More guidance will be coming in the weeks to follow.