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Capitol to Capitol | April 9, 2024

April 9, 2024

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Administration Updates

Medicaid Renewals: New Rule and Guidance

The Centers for Medicare & Medicaid Services’ announcement about an extension of the special enrollment period for marketplace coverage comes amid recent estimates that over 5 million Medicaid enrollees have lost coverage because they are no longer eligible and that millions more are still waiting for their redetermination status before unwinding wraps up. The special period began January 2023 for qualified individuals and their families losing Medicaid or Children’s Health Insurance Program coverage as part of the unwinding process in states offering coverage via Initially scheduled to end on July 31, the CMS has extended the date to Nov. 30 in anticipation that some states will need to extend their initial unwinding timelines, which is optional for state-based marketplaces. Read more.

The administration also announced a final rule that simplifies and standardizes the enrollment and renewal processes for Medicaid, CHIP and the Basic Health Program (an optional program for low-income residents). Among other things, the rule:

  • Eliminates annual and lifetime limits on children’s coverage in CHIP.
  • Ends the practice of locking children out of CHIP coverage if a family is unable to pay premiums.
  • Eliminates waiting periods for CHIP coverage so children can access health care immediately.
  • Improves the transfer of children from Medicaid to CHIP when a family’s income rises.
  • Requires states to provide all individuals with at least 15 days to provide any additional information when applying for the first time and 30 days to return documentation when renewing coverage.
  • Prohibits states from conducting renewals more frequently than every 12 months and requiring in-person interviews for older adults and those with disabilities.

Earlier in the month, CMS announced the following new guidance and tools related to renewals:

Labor Department Issues Final ‘Walkaround’ Rule

The Department of Labor released a finalized update to the Worker Walkaround Representative Designation Process or the ‘walkaround’ rule as it is commonly known. This update is consistent with current law and OSHA’s application of its regulation (29 CFR 1903.8(c)), but clarifies that “representative(s) authorized by employees may be an employee of the employer or a third party; such third-party employee representative(s) may accompany the OSHA Compliance Safety and Health Officer (CSHO) when they are reasonably necessary to aid in the inspection.”

Proponents of the reestablished definition believe it provides workers a stronger voice in the workplace assuming they will not fear retaliation to raise safety and health concerns if represented during inspections.  Conversely, others believe while workplace safety and health are imperative, this rule focuses largely on union organizing.

Employees were afforded the right to union representation from the 2013 Fairfax Memo that was challenged in a 2016 lawsuit by the National Federal of Independent Businesses.  The Fairfax Memo was rescinded in 2017. 

The final rule was published to the Federal Register on April 1 and will go into effect on May 31.

Read the Department of Labor news release here.

DOT Announces $5B for Transformative Infrastructure Projects

The Department of Transportation has opened applications for $5.1 billion in transportation project funding that will be made available through the National Infrastructure Project Assistance, Infrastructure for Rebuilding America and Rural Surface Transportation Grant programs. The funding, available through a streamlined competitive grant process, is intended to support regionally and nationally significant transportation projects. Eligible projects  may include those that are difficult to fund due to their size and complexity, such as highways, bridges, tunnels, ports, multimodal freight, passenger rail and other public transportation projects. Applications for this funding will close on May 6. Read more

Office of Management and Budget Issues Government-Wide Guidance on Federal Agency Handling of AI

The guidance establishes new federal agency requirements for artificial intelligence governance, innovation and risk management. As state policymakers continue to explore how to safely and effectively use AI, they can use the OMB guidance to inform their own handling of AI tools and services in routine state and local government operations. Read more

National Telecommunications and Information Administration Accepting Applications for State Digital Capacity Grants

This grant program will make $1.25 billion available to states and territories to begin implementing their digital equity plans, which identify barriers certain populations face in bridging the digital divide. States, D.C., and Puerto Rico must apply by May 28, and other territories by July 31. The application period for tribal entities begins Sept. 25 and closes Feb. 7, 2025. Read more.

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