The Effects of Expiring Pandemic Relief Measures on Coverage and Affordability: A Future Outlook

July 15, 2022

In light of the COVID-19 public health emergency (PHE), the federal government implemented temporary changes to routine Medicaid, CHIP, and Marketplace eligibility and enrollment operations to help stabilize insurance coverage. Medicaid and CHIP enrollment has grown to nearly 85 million individuals due largely to the continuous enrollment condition. Over 3 million new consumers have joined the Marketplace due partly to enhanced premium tax credits from the American Rescue Plan Act of 2021 (ARPA). However, ARPA’s enhanced and expanded subsidies are only authorized through the end of 2022. Additionally, Medicaid eligibility flexibilities and increased matching funds will terminate shortly after the PHE declaration ends, with Medicaid disenrollment potentially beginning as early as November 2022. As a result, the corresponding increases in coverage numbers could be temporary, leaving federal policymakers to decide whether and how to extend these policies.

This event outlined the various coverage-related elements at play over the next six to nine months, their tradeoffs, and how they may impact various stakeholders, including consumers, state leaders, and payers. Panelists will explore enrollment, risk pool, and premium forecasts, approaches that state and health plan leaders may take, as well as implications on overall costs to the system.

Speakers:

  • Scott Brockman, ASA, MAAA, Vice President, Marketplace Strategy, CareSource
  • Sara Collins, Ph.D., Vice President for Health Care Coverage and Access, Commonwealth Fund
  • Katie Keith, J.D., MPH, Director, Health Policy and the Law Initiative, O’Neill Institute for National and Global Health Law, Georgetown University Law Center
  • Kevin Patterson, MPA, MURP, Chief Executive Officer, Connect for Health Colorado
  • Elizabeth Wroe, J.D., Principal, Leavitt Partners
  • Sarah J. Dash, MPH, President and CEO, Alliance for Health Policy (moderator)

This event was made possible with support from the Commonwealth Fund.

Presentation: The Effects of Expiring Pandemic Relief Measures on Coverage and Affordability: A Future Outlook

Event Resources

Key Resources

(listed chronologically, beginning with the most recent)

“Emergency Declarations and Waiver Authority.”  McDermott Plus Consulting.  June 22, 2020.  Available

Averting Premium Shock for Marketplace Consumers.”  Keith, K.  The Commonwealth Fund.  May 26, 2022.  Available here.

“Mitigating Coverage Loss When the Publish Health Emergency Ends.”  Corlette, S., Kona, M.  The Commonwealth Fund.  April 26, 2022.  Available here.

“What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access.”  Cubanski, J., Kates, J., Guth, M., et al. Kaiser Family Foundation.  April 8, 2022. Available here.

“Medicaid Provisions in the American Rescue Plan Act.”  Musumeci, M. Kaiser Family Foundation.  March 18, 2021.  Available here.

Additional Resources

(listed chronologically, beginning with the most recent)

“Americans Are on the Brink of Experiencing Premium Pain and Health Insurance Loss.”  Collins, S.  The Commonwealth Fund.  July 13 2022.  Available here.

“Drivers of 2023 Health Insurance Premium Changes.”  American Academy of Actuaries.  June 2022.  Available here.

“Drivers of 2023 Premium Changes: Effects on Premiums Infographic.”  American Academy of Actuaries.  June 2022.  Available here.

“Family First Prevention Services Act.”  NCSL.  April 26, 2022.  Available here.

“The Coronavirus Aid, Relief, and Economic Security Act: Summary of Key Health Provisions.”  Moss, K., Wexler, A., Dawson, L., et al. Kaiser Family Foundation.  April 9, 2022.  Available here.

“Learning from COVID-19-Related Flexibilities: Moving Toward More Person-Centered Medicare and Medicaid Programs.”  The SCAN Foundation, Manatt Health, and Health Management Associates.  March 2022.  Available here.

“Next Big Health Crisis: 15M People Could Lose Medicaid when Pandemic Ends.”  Messerly, M.  POLITICO.  March 2, 2022.  Available here.

“PHE Unwinding for States.”  Princeton University, State Health and Value Strategies.  March 11, 2022.  Available here.

“Millions of Children May Lose Medicaid: What Can Be Done to Help Them From Becoming Uninsured.”  Alker, J.  Brooks, T.  Georgetown University Health Policy Institute Center for Children and Families.  February 17, 2022.  Available here.

“Public Health Emergency Declarations.”  U.S. Department of Health and Human Services.  January 14, 2022.  Available here.

“Counties and the ARPA Recovery Fund: Executive Summary.” NACO. January 13, 2022. Available here.

Experts

Speakers

Sara Collins, Ph.D.
Commonwealth Fund, Vice President for Health Care Coverage and Access
src@cmwf.org 

Sarah Dash, MPH 
Alliance for Health Policy, President and Chief Executive Officer
sarahdash@allhealthpolicy.org 

Katie Keith, J.D., MPH
Health Policy and the Law Initiative with the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, Director
Katie.Keith@georgetown.edu 

Kevin Patterson, MPA, MURP 
Connect for Health Colorado, Chief Executive Officer
executivedirector@connectforhealthco.com 

Elizabeth Wroe, J.D.
Leavitt Partners, Principal Partner
elizabeth.wroe@leavittpartners.com 

Experts and Analysts

Stephanie Anthony, J.D., MPH 
Manatt Health, Senior Advisor
santhony@manatt.com 

James Capretta, MPP 
American Enterprise Institute, Resident Fellow and Milton Friedman Chair
jcapretta@aei.org 

Debbie Curtis
McDermott+Consulting, Vice President,
Dcurtis@mcdermottplus.com 

Charlene Frizzera 
CF Health Advisors, Co-founder and President
cfrizzera@cfhealthadvisors.com 

Genevieve M. Kenney, Ph.D., M.A. 
Urban Institute, Senior Fellow and Vice President of Health Policy Center
jkenney@urban.org 

Jennifer Podulka, MPA
Health Management Associates, Principal
jpodulka@healthmanagement.com

Tim Westmoreland, J.D.
Georgetown Law, Professor
westmort@law.georgetown.edu 

Rodney L. Whitlock, Ph.D. 
McDermott+Consulting, Vice President
RWhitlock@mcdermottplus.com 

Government

Marvin Figueroa, Ed.M. 
U.S. Department of Health and Human Services, Director of the Office and Intergovernmental and External Affairs
Marvin.figueroa@hhs.gov 

Carries Hughes, M.A. 
House Education and Labor Committee, Health and Human Services Director
Carolyn.hughes@mail.house.gov 

Hannah Katch, MPP
Centers for Medicare and Medicaid Services (CMS), Senior Policy Analyst
Hanna.katch@cms.hhs.gov 

David Meyers, M.D. 
U.S. Department of Health and Human Services, Deputy Director at Agency for Healthcare Research and Quality
David.meyers@ahrq.hhs.gov 

Stakeholders

Frederick Isasi, J.D., MPH 
Families USA, Executive Director
fisasi@familiesusa.org 

Hannah Maniates, MPH 
National Association of Medicaid Directors, Policy Analyst
Hannah.maniates@medicaiddirectors.org 

Hemi Tewarson, J.D., MPH 
National Academy for State Health Policy (NASHP), President and Executive Director
htewarson@nashp.org 

Aaron Wesolowski 
American Hospital Association (AHA), Vice President of Policy Research, Analytics, and Strategy
awesolowski@aha.org 

Transcript