On October 21, 2021, ADvancing States, the National Association of Medicaid Directors, the National Association of Directors of Developmental Disabilities Services, and the National Association of State Mental Health Program Directors sent letters to the US Department of Health and Human Services (HHS) and Congress regarding the COVID-19 public health emergency (PHE) declaration. Specifically, the letter to HHS requests that:

• Recognizing that COVID may surge again in the future, that the nation has not yet reached herd immunity levels for immunization, and that efforts to provide initial vaccinations and boosters to remain ongoing, we request that HHS signal to states that it is unlikely to end the PHE before July 1, 2022. This will provide states with adequate time to prepare for the significant operational changes associated with the end of the PHE and, for many states, align with the beginning of the fiscal year.
• HHS end the PHE on the first day of a fiscal quarter. This will provide a full quarter of enhanced federal match for Medicaid expenditures, as allowed under current law, while Medicaid programs resume normal operations and begin processing redeterminations for the millions of enrollees across the country who have remained on the program during the PHE. This will also ensure Medicaid enrollees receive a full month of coverage under current statute before disenrollments begin.
• HHS increase its commitment for advance notice of the end of the PHE from the current 60 days to the maximum 90 days allowed under statute to provide states with as much planning time as possible.

Similarly, the letter to Congress requests that lawmakers:

• Decouple the Families First Coronavirus Response Act (FFCRA)’s 6.2 percentage point Federal Medical Assistance Percentage (FMAP) enhancement from the PHE. Instead, provide certainty for states by offering this enhancement for 12 months following the end of the month in which the PHE ends.
• Mitigate a fiscal cliff for Medicaid programs by gradually phasing out the FFCRA FMAP enhancement over at least three quarters after this 12-month post-PHE period.
• Beginning July 1, 2022, sunset the Medicaid continuous enrollment requirement that is a condition of receipt of FFCRA’s FMAP enhancement. This will provide states with certainty for budgeting and enrollment projection purposes and, for many states, align with the beginning of the fiscal year.

Click here to view the letter to HHS

Click here to view the letter to Congress