June 6, 2023

Feds approve Washington’s continuous enrollment amendment request for children

And other waiver-related activities

The federal Centers for Medicare & Medicaid Services (CMS) recently approved a 2021 amendment request for our state’s Section 1115 Medicaid demonstration waiver. We call this waiver the Medicaid Transformation Project (MTP).

In 2021, the Health Care Authority (HCA) and Department of Social and Health Services (DSHS) requested that children who are eligible for Apple Health (Medicaid) remain enrolled in Apple Health until they reach age six, regardless of circumstances.

With this approval, our state can provide ongoing health care coverage for our youngest and more vulnerable population. This change can improve health outcomes for children by minimizing gaps and creating stable health care coverage.

Our approved request applies to the current MTP waiver and will continue under MTP 2.0, if approved. View CMS’ approval letter, which includes additional approved requests under the 2021 amendment.

Other MTP activities

MTP 2.0, CMS negotiations, and a short extension

In July 2022, HCA and DSHS applied to CMS to renew MTP for an additional five years. We call the MTP renewal “MTP 2.0.” Negotiations with CMS began in October 2022 and still continue—and because discussions for MTP 2.0 did not end on December 31, 2022—CMS approved a short extension to our current MTP waiver. MTP will now end June 30, 2023.

If approved, MTP 2.0 will begin July 1, 2023.

Current (2023) amendment request

HCA and DSHS are now working on another amendment to the current MTP waiver, which would authorize:

• Medicaid coverage for former foster care youth—also known as Alumni coverage in Washington—from other states who turned 18 prior to January 1, 2023.
• Continuous enrollment for the Children’s Health Insurance Program (CHIP) coverage for CHIP children during the first six years of their lives.

The public comment period for this amendment request ended on May 22. We will use people’s feedback to further refine the application we’ll be submitting to CMS soon. If approved, this request will apply to the current MTP waiver and continue under MTP 2.0 (if approved).

COVID-19 Public Health Emergency (PHE) amendment request

In May, our state also received approval from CMS to receive federal match for those who aged out of CHIP coverage during the PHE. Our state previously provided continuing coverage without federal match for all youth who aged out of CHIP coverage during the PHE. (Youth age out of CHIP at 19 years old.)

About MTP

MTP is an agreement between our state and CMS that allows us to create and continue to develop projects, activities, and services that improve Washington’s health care system. All work under MTP benefits those enrolled in Apple Health.