2024 Medicaid Changes: In 2024, Medicaid will be characterized by several major issues that will affect access to healthcare, cost, and coverage. The main issue is the Medicaid continuous enrollment rule, which stopped people from dropping out during the pandemic but began to phase it out in April 2023.
According to Texas Tribune, about 1.8 million Texans get Medicaid coverage from six managed care organizations across the state. Next year, these people will lose their current health plans and be switched to new ones if Texas Health and Human Services sticks to its recent decision to redistribute the contracts after a bidding process.
The change would mean fewer managed care organizations running the state’s Medicaid STAR and Children’s Health Insurance Program. There would be a shift away from local MCOs in the majority of the state, a decrease in the number of top-rated plans in charge of care, and the introduction of new national plans in regions that were previously under the control of local MCOs.
Even though the renewal process is ongoing, this change is still a big policy concern. By January 2024, about half of the people who signed up had their coverage extended. However, a large number were still at risk of being dropped, usually for administrative reasons.
Federal interventions and state action are being called for to mitigate procedural disenrollments due to the probable loss of coverage, particularly for vulnerable populations such as children.
Increasing Medicaid access and coverage is another crucial issue. While some states are debating whether to expand Medicaid under the Affordable Care Act, others are dealing with the coverage gap affecting millions without health insurance. In some places, the American Rescue Plan Act starts new arguments by giving short-term growth incentives. Politics could affect the future of Medicaid. For example, some areas might not want to expand, and there could be changes at the government level.
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Socioeconomic determinants of health (SDOH) need to be fixed, and it’s getting easier for people who have been in jail to get back into society. With help from federal efforts and flexibility, states are focused on using Medicaid to deal with SDOH issues like not having enough food and losing their homes.
Legislative actions and waivers are also used in reentry assistance programs for the incarcerated to guarantee Medicaid coverage after release.
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Shortages of workers present difficulties, especially in the fields of behavioral health and long-term services and supports (LTSS). The new rules are meant to make it easier for people in the community to get LTSS and to fix staffing problems in nursing homes. There are also plans to lower administrative costs and raise rates to improve the mental health staff.
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Medicaid funding is closely tied to the economy. The fact that government benefits from the pandemic are ending and state revenue growth is slowing down makes rising state costs worse. When states negotiate their budgets for FY 2025, they may limit how much they can spend on Medicaid. This could lead to discussions about spending during the election for president.
There will be a lot of different social, economic, and governmental factors that affect Medicaid in 2024. Suppose states and federal partners want to make sure that vulnerable groups can get critical health care. In that case, they need to focus on ending continuous enrollment, expanding coverage, fixing SDOH, increasing staff capacity, and dealing with money issues.
