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CMS FAQ on Medicaid Continuous Eligibility for Children

The Centers for Medicare & Medicaid Services (CMS) released FAQ related to the Consolidated Appropriations Act, 2023 requirement for mandatory continuous eligibility for children in Medicaid and the Children’s Health Insurance Program (CHIP).

Starting Jan. 1, 2024, states operating a CHIP separate from the Medicaid program will not be able to terminate CHIP coverage for nonpayment of premiums during a continuous eligibility period. These states still can institute a CHIP enrollment fee and require payment of the fee prior to enrollment. They also retain the option to require payment of the first month’s premium prior to enrolling a child in CHIP.

Further, if a state or managed care entity covers unpaid premium amounts for a child whose coverage must be maintained during a continuous eligibility period despite nonpayment of premiums, the state cannot receive federal financial participation for the amount.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Julie Kozminski is a policy manager at America's Essential Hospitals.

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