2022 Changes for Medicaid and Cigna

Study shows millions could lose Medicaid coverage once Covid emergency ends

A recent Urban Institute study looked into what will happen to Medicaid enrollments once the Covid Public Health Emergency (PHE) expires, possibly as soon as the end of 2021. Last year, the federal government passed a law prohibiting states from disenrolling Medicaid beneficiaries for the duration of the PHE. While important in helping manage the Covid crisis, the law’s unintended consequence was to balloon Medicaid enrollment by upending the normal process in which people join and leave the program on a continual basis, keeping enrollment growth at a slower, steady pace.

The study estimates that as many as fifteen million people may now be enrolled in Medicaid who will no longer qualify for coverage once the PHE ends. States will have up to a year to restore their previous enrollment criteria. The study authors wrote that states need to take advantage of this grace period by giving patients time and advice for finding new coverage options. Regarding those options, the study calculated that about a third of adults and two thirds of children who will lose Medicaid will be eligible for other subsidized coverage through the ACA exchanges or the Children’s Health Insurance Program (CHIP). To ensure continuity of care, providers who serve Medicaid populations should prepare their practices to counsel any affected patients regarding these options.

Oscar Health partnering with Cigna to expand into Illinois

Oscar Health, a technology driven upstart health insurance company, recently announced a joint venture with Cigna to expand into Chicagoland, with the goal of eventually spreading to more Illinois counties. Per Oscar’s corporate description, the company seeks to improve healthcare access, quality, and affordability with a “full stack technology platform and a relentless focus on serving its members.” The company started in New York in 2012 during the early days of the Affordable Care Act.

The joint venture, labeled Cigna + Oscar, will begin with a small business plan (up to 50 employees) in five counties including Cook, DuPage, Kane, Lake, and McHenry. It will utilize Cigna’s LocalPlus and Open Access Plus networks, but Oscar’s consumer-friendly technology. The deal is pending regulatory approval and no start date has been announced, but expect to see enrollment start for next year. Providers already enrolled in these Cigna networks should be able to see Cigna + Oscar patients without additional credentialing.