The Government Accountability Office Issues a New Report on Medicaid

During the COVID-19 public health emergency, Congress provided temporary enhanced federal funding to states to keep enrollees continuously enrolled in Medicaid. Beginning in April 2023, states resumed full eligibility redeterminations (unwinding). States had flexibility in the in their pace of unwinding and many states were still in the process as of May 2024. The CARES Act includes a provision for the Government Accountability Office (GAO), the federal agency that examines how taxpayer dollars are spent, to report on the federal response to the COVID-19 pandemic. Among other things, this report examines the Centers for Medicare & Medicaid Services (CMS) oversight of Medicaid unwinding. The unwinding of the continuous Medicaid coverage provision has resulted in over 22 million enrollees being disenrolled as of May 23, 2024, and over 49 million have had their coverage renewed.  GAO reviewed documentation of CMS’s efforts to assess state compliance with federal unwinding requirements and resolve any noncompliance from March 2023 through April 2024 and interviewed CMS officials about plans for future oversight. According to the report, during the unwinding, CMS found compliance issues with federal redetermination requirements in almost all states, including with long-standing requirements. GAO is recommending that CMS document and implement the oversight practices the agency learned during unwinding were needed for preventing and detecting states compliance issues with redetermination.

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