Medicaid Unwinding in the Northern Mariana Islands: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in the Commonwealth of the Northern Mariana Islands (CNMI) are changing because of the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This is expected to lead to a loss of coverage for millions of people through a process called unwinding.
During the PHE, Medicaid renewals were automatic and enrollees had continuous coverage. As part of the unwinding process, automatic renewals for Medicaid and Children’s Health Insurance Program (CHIP) coverage stopped nationwide on March 31, 2023.
Medicaid in the CNMI works differently than the programs in the 50 U.S. states and the District of Columbia. For instance, the Commonwealth Medicaid Agency is no longer accepting online applications.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020, which was renewed a dozen times through February 2023.
During the COVID PHE, Medicaid enrollees were able to keep their health insurance coverage without eligibility reviews. That’s because states and territories were required to provide continuous coverage during the pandemic.
But the PHE ends on May 11, 2023, along with automatic renewals for Medicaid enrollees. At that point, some people in the Commonwealth of the Northern Mariana Islands (CNMI) may lose Medicaid or Children’s Health Insurance Program (CHIP) coverage.
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Commonwealth Medicaid Agency officials are resuming reviews of Medicaid and CHIP enrollees to determine who is now eligible for coverage through a process called redetermination. If you or your family members no longer qualify for Medicaid or CHIP, you could lose coverage as early as May 1, 2023.
Here’s how to prepare for Medicaid changes in the CNMI and what to do if you lose coverage.
Why is Medicaid changing nationwide?
After the PHE ends, COVID-19 will remain a public health priority — just not an emergency. As part of this process, Medicaid renewals will no longer be automatic. This is being referred to as the unwinding of Medicaid, and millions of people nationwide risk losing coverage.
The unwinding process will affect Medicaid in every state, the District of Columbia, and the five U.S. territories, including the CNMI.
What’s happening with Medicaid renewal in the Northern Mariana Islands?
The CNMI State Administration office is responsible for overseeing the Commonwealth Medicaid Agency, which runs the state’s program — sometimes referred to as the Medical Assistance for the Needy (MAN) program. The CNMI’s Medicaid program works differently than state programs. Now that continuous coverage has ended, CNMI Medicaid and CHIP plans are expiring.
CNMI officials are reviewing the eligibility of everyone with Medicaid or CHIP, which means that it’s time to reapply. Medicaid enrollees who qualify under “presumptive eligibility” — typically because of income and a qualifying condition — can expect their coverage to end on May 11, 2023. The Commonwealth Medicaid Agency plans to have all unwinding eligibility reviews finished by January 2024.
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If you’re a CNMI resident who loses coverage or needs to renew your Medicaid or CHIP, you will need to reapply through the Commonwealth Medicaid Agency. But online applications are no longer accepted. You must download “original” forms and complete your renewal on paper. Then, bring your application and supporting documents to 1 of 3 locations:
Saipan: Capital Hill, Government Building 1252, 7:30AM to 1 PM (CHST), Monday through Thursday (closed on Fridays)
Tinian: Tinian Health Center, 7:30AM to 4:30PM (CHST), Monday through Friday
Rota: Rota Health Center, 7:30AM to 4:30PM (CHST), Monday through Friday
You don’t have to — and shouldn’t — wait until your expiration date to submit your application; you can bring it to one of the locations at any time. It’s advised that you apply at least 1 month before your coverage is set to end, because redeterminations take 45 to 60 days from the application filing date.
The sooner you reapply, the sooner you’ll have your renewal review and find out if you still qualify for coverage. Applying as soon as possible will also help you avoid a disruption in your Medicaid or CHIP coverage if you remain eligible.
You can reach the Commonwealth Medicaid Agency by phone at 670-664-4880 or 670-664-4882. You can also email info@cnmimedicaid.org for more information.
What should I do if I lose my Medicaid coverage in the Northern Mariana Islands?
If the Commonwealth Medicaid Agency doesn’t renew your coverage during the redetermination process, you will no longer be able to use your benefits, which could leave you temporarily uninsured.
To receive Medicaid in the CNMI, you must live in the commonwealth and have one of these citizenship statuses:
U.S. citizen
U.S. national
Freely Associated States (FAS) citizen
Qualified alien
Once you meet the citizenship and residency conditions, you may qualify for coverage under several circumstances:
Supplemental Security Income (SSI) recipients are automatically eligible, but they must file an application.
If your income meets the limit for your household size, you may be eligible.
If your income exceeds the limit but you qualify for the spend-down program, you may be eligible.
If you no longer meet the eligibility guidelines, your Medicaid in the CNMI won’t be renewed.
If you lose coverage but believe you still qualify, you should reapply for Medicaid in the CNMI. You may be uninsured for a while if you reapply for coverage and need to wait to be approved again. In that case, you may want to explore free and low-cost healthcare options. You also may be able to use free GoodRx coupons to save on your prescription medications.
You can also seek care through the Commonwealth Healthcare Corporation, which operates the only territory hospital and emergency department, as well as outpatient clinics and all CNMI public health functions.
If you live in the CNMI, you are not eligible to use the Affordable Care Act (ACA) marketplace to find healthcare coverage. But, depending on your circumstances, you may be able to find health insurance through one of these options:
Employer plan: You may be able to get employer-sponsored healthcare if you have a job that offers health insurance benefits.
Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.
Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.
Special plans: Short-term insurance can be a great choice if you anticipate a better option, like job-based health insurance, to be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance plans.
Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.
U.S. Department of Veterans Affairs (VA): If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.
Northern Mariana Islands Medicaid resources
Here are some resources you can use to learn more about Medicaid in the CNMI and upcoming changes related to the end of the PHE:
Northern Mariana Islands Medicaid office: The CNMI State Administration office oversees the Commonwealth Medicaid Agency, which runs the CNMI’s program, sometimes called the MAN program.
Renewing your Medicaid or CHIP: You cannot apply online for coverage through the Commonwealth Medicaid Agency. You must download “original” forms, complete your renewal on paper, and bring your application and supporting documents to 1 of 3 locations.
Need help or have questions?: You can reach the Commonwealth Medicaid Agency by phone at 670-664-4880 or 670-664-4882. You can also email info@cnmimedicaid.org for more information.
The bottom line
Automatic Medicaid renewals stopped on March 31, 2023, ahead of the COVID-19 public health emergency (PHE) ending May 11, 2023. As part of that, the Commonwealth Medicaid Agency, which runs Medicaid and the Children’s Health Insurance Program (CHIP) in the Commonwealth of the Northern Mariana Islands (CNMI), has started reviewing Medicaid eligibility for enrollees.
This redetermination process is working differently than in the 50 U.S. states and the District of Columbia. Everyone with Medicaid and CHIP — including those who have “presumptive eligibility,” such as individuals receiving Supplemental Security Income (SSI) — must reapply. And there are no online Medicaid applications in the CNMI, so residents will need to download forms, complete them on paper, and then submit them in person at 1 of 3 locations.
People who live in the CNMI are not eligible to use the Affordable Care Act (ACA) marketplace to find coverage, but they do have access to healthcare through the Commonwealth Healthcare Corporation.
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References
Administration for Strategic Response and Preparedness. (2020). Determination that a public health emergency exists.
Administration for Strategic Response and Preparedness. (2023). Renewal of determination that a public health emergency exists.
Commonwealth Medicaid Agency. (n.d.). Continuous coverage info-sheet.
Commonwealth Medicaid Agency. (n.d.). Eligibility and application for Medicaid.
Commonwealth Medicaid Agency. (n.d.). Spend down info-sheet.
Commonwealth of the Northern Marianas Islands Office of the Governor. (2023). Medicaid continuous coverage update.
Medicaid.gov. (n.d.). Medicaid & CHIP in Northern Mariana Islands.
Medicaid.gov. (2023). Unwinding and returning to regular operations after COVID-19.
Tolbert, J., et al. (2023). 10 Things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
U.S. Department of Veterans Affairs. (2022). VA & TRICARE information.
