What the End of the Public Health Emergency will Mean for Access to Care in Utah

Did you know that Utah is still in a Public Health Emergency (PHE)? The PHE began at the onset of the Covid-19 Pandemic in 2020 through declaration by the Federal Government and has continued since. Though the specifics of the PHE orders have changed throughout the course of the ongoing pandemic to meet public health needs, one important constant has been the requirement that state Medicaid Agencies continue Medicaid coverage for all members, even if their eligibility changes. This means Utahns on Medicaid have not had to worry about losing coverage or having to regularly reapply for eligibility during the ongoing health emergency. The PHE was most recently being renewed in October 2022 and can be extended for 90 days at a time and, if not renewed in the coming weeks, is set to expire on January 13^th, 2023. The natural result has been an overall increase in the number of Utahns on Medicaid.  

This will change when the Public Health Emergency ends and begins what will be known as “unwinding.” The Federal Government has pledged to give the state a 60-day warning before unwinding. Fortunately, the Utah Department of Health and Human Services (DHHS) has very clear guidance on how the process is to occur. When the PHE ends and the DHHS begins to review over 12 months the upwards of 363,522 Medicaid cases in our state, we will be closely monitoring the possibilities of coverage loss and coverage gaps for current Medicaid members. The DHHS has acknowledged challenges in the unwinding process, some of which may lead to coverage loss. These include contacting Medicaid members to reapply for coverage, who may have moved or changed contact information during the pandemic, as well as the possibility for other mistakes to be made that result in inappropriate loss of coverage. Another thing we will be keeping our eye on is state losing the 6.2% enhanced federal funding (FMAP) at the end of the quarter that the PHE concludes.  

Access to care is a critical priority for the American Heart Association. Through our work with DHHS, relevant state agencies, the Governor’s Office, and the State Legislature, we will work to ensure that the process runs as smoothly as possible. 

Overall, the state has a robust unwinding plan in place. The DHHS has created helpful resources to stay apprised of the process that can be found at https://medicaid.utah.gov/unwinding/, which will soon include a dashboard to monitor overall review progress, the results of reviews, and other key metrics.