CMS won’t renew Medicaid continuous enrollment, workforce programs

Modern Healthcare – Thursday, July 17, 2025
By Bridget Early

The federal government won’t approve or renew state programs to promote multiyear, continuous Medicaid enrollment or health professional workforce development, the Centers for Medicare and Medicaid Services announced Thursday.

Affected 1115 waivers will operate until their original approvals run out, then cease, Center for Medicaid and Children’s Health Insurance Program Services Director Drew Snyder wrote in a pair of memoranda.

The strategic shift will bring an end to waivers that extend the amount of time Medicaid and CHIP enrollees may retain coverage without eligibility redeterminations, along with workforce development demonstrations.

Instead, CMS will revert to the statutory minimum laid out in the Consolidated Appropriations Act of 2023, which requires states to provide 12 months of continuous Medicaid and CHIP eligibility for children, and of the American Rescue Plan Act of 2021, which allows states to offer 12 months of continuous eligibility for postpartum coverage.

“CMS has concerns about the appropriateness of providing continuous eligibility for additional populations and for longer durations of time than are required or available under the Medicaid and CHIP state plans, which could affect fiscal and program integrity,” Snyder wrote.

But 1115 waivers, which are typically approved for five-year periods, have long been used to provide multiyear coverage for some categories of Medicaid and CHIP enrollees. In November, for instance, CMS approved such continuous coverage waivers for Colorado, Hawaii, Minnesota, New York and Pennsylvania.

A dozen states have multiyear continuous eligibility waivers in place, which are set to expire between this year and 2029, according to CMS data compiled by the health policy research institution KFF.

Nine states have these continuous enrollment waivers for children and eight states have them for adults. Some have both.

Five states have workforce development programs that use Medicaid funding to support job training and related activities for primary care, behavioral health, dental, and home- and community-based services professionals.

The new stance from CMS comes amid a period of tumult in Medicaid and in the insurance sector.

Last year, CMS and states completed an arduous continuous coverage unwinding process in the aftermath of the COVID-19 pandemic, which saw more than 25 million beneficiaries removed from the rolls after eligibility redeterminations.

A second wave of disenrollments is on the horizon after President Donald Trump enacted $940 billion in Medicaid cuts in the “One, Big Beautiful Bill,” which is expected to cause millions of enrollees to become uninsured.

CMS did not immediately respond to written questions.

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