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.Health and Social Security Secretary Alex Azar and Assistant Secretary for Health Jonathan A. Adelstein have sent a letter to the Senate Finance Committee Chairman Charles E. Grassley, R-Iowa, and Ranking Member Ron Wyden, D-Ore., that hews closely to one of the recommendations made by the commission: clarifying the requirements for an initial application for Medicaid and making the number of days an applicant has to apply under the rule.

The commission, which was set up in 2010 as part of the Affordable Care Act, included Medicaid benefits, some school financial aid and states’ Medicaid waiver programs as targets for reform. When the ACA became law, it created millions of new Medicaid enrollees in a program that covers nearly half of the nation’s poor, disabled and working people.

The Health and Human Services Department said in the letter it plans to release a proposed rule to address the report’s other recommendations in the coming weeks.

The commission’s letter echoed the Health and Human Services Department’s justification for its delay in deciding whether to drop a waiver program known as the Children’s Health Insurance Program, CHIP.

Adelstein said he’s inclined to wait until the commission issues its final report. It is due out this fall.

“We think it’s important that we get the final report from the commission before making any decision about CHIP,” he said.

Sens. Patty Murray, D-Wash., and Lamar Alexander, R-Tenn., are sponsors of legislation to reform Medicaid that would create states-based programs that use a combination of federal and state money. They have proposed a change in federal matching rates that would allow states to shift those costs to newly eligible residents.

The senators met with HHS and said after the meeting that they expect to see the agency propose major Medicaid changes in the coming months.

“The failure of the law to provide some funding for some of these things have created a crisis in the economy and frankly have caused an unnecessary burden on those people that are growing the economy,” Murray said.

Murray said that since the ACA was enacted, 11 million people have gained insurance coverage through Medicaid, Medicare and private programs.

“The children’s health program has the highest number of enrollees,” she said. “The maximum out-of-pocket cost is $6,000 a year for low-income children. So we’ve got to make sure the children are protected and the children’s health program is protected.”

Murray said

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