Fold Medicaid and CHIP into UHP

Year 4 (dual eligibles and children earlier) · States; UHADiscuss this step

Every concrete action this step requires, who is responsible, and when it happens relative to enactment.

#	Action	Owner	When	Trade-off
4.3.1	Terminate Medicaid MCO contracts with 90-day run-out.	States	Year 4	A 90-day MCO run-out is quick but may disrupt care management for complex patients.
4.3.2	Keep a residual Medicaid for non-medical supports (housing assistance pilots) at state option with federal match.	States / CMS	Year 4	A residual Medicaid keeps social supports but preserves state-by-state variation.
4.3.3	Transfer Medicaid provider enrollment and HCBS assessment data to UHA.	States / UHA	Year 3–4	Transferring data preserves continuity but requires states to cooperate on migration.
4.3.4	Begin monthly MOE payments to the Trust Fund.	States	Year 4	Monthly MOE payments are predictable but strain state cash flow in downturns.
4.3.5	Re-deploy or separate state eligibility staff (the worker program covers separated staff).	States	Year 4	Redeploying staff reduces layoffs but may not match skills to new roles.
4.3.6	Decommission state Medicaid eligibility systems; MMIS systems retained 7 years for audits.	States	Years 4–5	Keeping MMIS systems for audits is prudent but costs money for systems no longer in use.