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Bill to Prevent Gap in Health Coverage for Those Who Lose Access to Medicaid Passes Committee


TRENTON – Legislation sponsored by Senator Joe Vitale that would make sure residents who become ineligible for Medicaid coverage are enrolled in a health plan under the State-based exchange cleared the Senate Health, Human Services and Senior Citizens Committee.


Under the bill, the Commissioner of Banking and Insurance would be required to automatically enroll an individual in a health benefits plan when that person becomes ineligible for coverage through Medicaid because they no longer meet the income requirements of the program.


Those who qualify for a zero-cost plan on the exchange would be automatically enrolled in the plan, while those who do not qualify for a zero-cost plan would have their coverage effective upon payment. The Department would be required to provide adequate notice to individuals being auto enrolled, including noting their right to opt out of the auto enrollment and information on how to select a different plan.


“The more people we can sign up and keep on our health insurance rolls, the better off we will be as a state,” said Senator Vitale (D-Middlesex), Chair of the Health Committee. “Continuous enrollment in coverage has shown to be effective and is the right thing to do. This will make us a healthier state on the whole; it will ensure people maintain access to the primary and preventive health care services they need, will hold down emergency room visits and other costs, and keep families from delaying critical treatment.”


As part of a federal aid package approved in the early days of the pandemic, Congress provided a 6.2 percent increase in the federal Medicaid match rate for states that provided continuous coverage for Medicaid enrollees until the end of the month in which the COVID public health emergency is declared over.


The continuous coverage provision in Medicaid is set to end on March 31.

The bill would seek to prevent a gap in or total loss of health insurance coverage for individuals who will be disenrolled from Medicaid as the continuous coverage provision winds down.


The bill is modelled after programs in California, Rhode Island, and Massachusetts.


The bill, S-3607, was released from committee by a vote of 6-2.