Continuous eligibility for Medicaid is being phased out, the Centers for Medicare & Medicaid Services has announced.

Characterizing its decision as one that follows more closely the statutory underpinnings of Medicaid and the Children’s Health Insurance Program, CMS explains that it “… is issuing guidance to states making clear it does not anticipate approving new or extending existing section 1115 demonstration authorities that have allowed some individuals to remain enrolled in Medicaid or CHIP for extended periods of time, even if they may not have otherwise been eligible.”

At the same time, CMS announced that it is taking a similar approach to the use of Medicaid funds for health care workforce development initiatives.

In both cases, CMS will not terminate existing waivers that enable continuous eligibility or the use of federal Medicaid funds for workforce programs.  Instead, it will neither renew current waivers when they expire nor issue future waivers for either purpose.

The loss of continuous eligibility would unquestionably harm community safety-net hospitals and the communities they serve.  Such hospitals serve larger numbers and higher proportions of Medicaid-covered and economically and medically vulnerable patients than the typical American hospital and therefore will see more of their patients lose their health care coverage.  That, in turn, will leave many community safety-net hospitals providing more uncompensated care and many low-income patients avoiding seeking care for their health problems because they have no insurance.

Learn more about CMS’s actions from its letter to state governments about its new approach to continuous eligibility; its letter to state governments about its decision about Medicaid-funded workforce development programs; and this CMS news release.