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Major Medicaid & CHIP Provisions in the Consolidated Appropriations Act of 2023

The Consolidated Appropriations Act of 2023, an omnibus federal appropriations bill that became law in December 2022, contains many critical provisions related to Medicaid and the Children’s Health Insurance Program (CHIP). A summary of these provisions is below.

Initiates Transition from the Medicaid Continuous Coverage Requirement

  • Ends the Medicaid continuous coverage requirement on March 31, 2023, even if the Public Health Emergency continues.
  • Missouri will begin reverification of eligibility for existing Medicaid participants in April.

Phases Out the Enhanced Medicaid Match Rate

  • Missouri received enhanced federal matching rates for Medicaid and CHIP during the public health emergency of 6.2% and 4.34% respectively. The enhanced rates will be phased out beginning April 1st and end on December 31st, as shown in the chart below.
  • As of June 30, 2022, Missouri had received $1.787 billion through the enhanced rate for Medicaid alone (not including the additional incentive for Medicaid Expansion).
  • Lawmakers used a portion of the state general revenue savings resulting from the enhanced rates to create a new “savings account” for Medicaid. Called the Medicaid Stabilization Fund, this account held $422 million as of June 30, 2022.

Phase-Out of the Enhanced Federal Match

 Enhanced Medicaid RateEnhanced CHIP Rate
January 1 – March 31, 20236.2%4.34%
April 1 – June 30, 20235%3.5%
July 1 – September 30, 20232.5%1.75%
October 1 – December 31, 20231.5%1.05%

Requires 12-Month Continuous Eligibility for Children

  • Requires states to provide 12-month continuous coverage for children in Medicaid and CHIP.
  • Although required beginning January 1, 2024, states can implement this sooner.

Extends State Option for 12-month Postpartum Coverage

  • Makes permanent the option for states to enact 12-months of postpartum coverage.

Extends Federal Funding for CHIP through Fiscal Year 2029

Invests in Mental Health Resources for Children & Youth

  • $140 million (an increase of $20 million), for Project AWARE, to develop school-based mental health services,
  • $94 million (an increase of $12 million) for the National Child Traumatic Stress Initiative, and
  • $15 million (an increase of $5 million) for Infant and Early Childhood Mental Health.

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