National Emergency Declaration Speeds Low-Income Health Care

Read Stateline coverage of the latest state action on coronavirus.

The national emergency declaration President Donald Trump delivered today increases states’ authority to help low-income residents get testing and treatment for the new coronavirus.

Trump’s declaration signals to governors that they can now apply to the U.S. Centers for Disease Control and Prevention for exemptions from some of the regulations governing Medicaid and the Children’s Health Insurance Program. If those requests are granted, it could help governors address the crisis in a variety of ways.

The exemptions could allow states to enroll people into Medicaid without all the documentation that is normally required. It could allow for reimbursement of telemedicine without many of the typical location restrictions. It could enable states, localities or hospitals to provide care in non-medical settings. And it could enable states to circumvent normal medical licensing requirements if they need help from out-of-state providers.

Under the waivers, normal health privacy rules could be relaxed, which would allow for more use of telemedicine. Hospital emergency rooms in a surge situation where they couldn’t treat all comers also would be free from the normal legal obligation that a hospital must stabilize any emergency patient regardless of ability to pay. Under a waiver, hospital emergency rooms could direct patients elsewhere without violating federal law.

“Medicaid has lots of rules and regulations that are important for the program’s integrity but that, in an emergency, you may want to push aside,” said Matt Salo, executive director of the National Association of Medicaid Directors. “The president’s declaration is the vehicle that allows that to happen.”

States still must apply to the Centers for Medicare & Medicaid Services for permission to waive those rules, and Salo said states are working with the Trump administration to ensure that process will move quickly. That has happened after other federal emergency declarations, typically in the case of natural disasters, Salo said.

Most of all, the emergency declaration will allow for speed, said Jessica Schubel, senior policy analyst of the Center on Budget and Policy Priorities, a left-leaning Washington, D.C., think tank. “The idea is you’re streamlining and making things faster to address the emergency at hand.”