‘PE may be extended past end of health emergency’

The National Public Health Emergency, which gave nearly everyone access to free or affordable medical care through Presumptive Eligibility Medicaid, is supposedly set to end on May 11. However, there may still be hope for another extension, thanks to the continuous coverage of the Consolidated Appropriations Act of 2023.

As the world continues to make positive strides toward treating the COVID-19 virus as an endemic instead of a pandemic, President Joe Biden recently informed the U.S Congress that he will end the twin national emergencies for addressing COVID-19 on May 11, specifically the National Emergency and Public Health Emergency declarations.

According to Commonwealth Healthcare Corp. CEO Esther Muña, Presumptive Medicaid is tied to the Public Health Emergency, but because of the continuous coverage of the Consolidated Appropriations Act of 2023, there is still hope for an extension past the end of the emergency declaration.

“We understand that the Presumptive Eligibility is connected to the Public Health Emergency declaration issued by the U.S. secretary of Health. However, there was an earlier indication that the PE would end after March 31, 2023, as part of the continuous coverage of the Consolidated Appropriations Act of 2023. This announcement does give hope for an extension up to May 31, 2023. We assume that the 60-day notice will be given in March to ensure this extension,” she said.

However, because the act would only extend PE another 60 days, CHCC is looking into ways to ensure that those who are receiving treatment and those with severe illnesses who depend on PE do not lose coverage.

“The Commonwealth Healthcare Corp. wants to work with Medicaid and all involved in policymaking to find solutions for those individuals that will lose coverage when the PE ends. We especially want to ensure that those currently receiving treatment for their severe illnesses, especially cancer and cardiovascular, have continuous coverage. Otherwise, the uncompensated costs of providing services will go to CHCC alone,” she said.

Presumptive Eligibility is an expedited process of enrolling eligible residents in the CNMI Medicaid program. It allows patients to have their care covered while waiting for their application to be fully processed.

It offers immediate access to healthcare while applying for regular Medicaid or other health coverage. You can start using PE for Medicaid coverage right away for Medicaid covered services, such as doctor visits, hospital care, and some prescription drugs.

Individuals and families are eligible for Medicaid if their attested gross income does not exceed 180% of the Supplemental Security Income federal benefit, which is about $28,800 annually for a family of four.