For months, public health experts have been sounding the alarm over many Medicaid enrollees losing their coverage with the winding down of the COVID-19 public health emergency.<\/p>\n\n\n\n
But that hasn\u2019t stopped thousands from being caught off guard now that the emergency is officially over.<\/p>\n\n\n\n
Federal legislation passed during the pandemic prohibited states from terminating a Medicaid enrollee\u2019s coverage until the end of the public health emergency, which enabled the federal program to grow and contributed to a record-low national uninsured rate.<\/p>\n\n\n\n
These provisions have concluded, however, and it\u2019s become apparent that beneficiaries were not made aware of the change.<\/p>\n\n\n\n
In a Kaiser Family Foundation (KFF) poll released this week, two out of three Medicaid enrollees said they were \u201cnot sure\u201d if states could remove people from Medicaid for no longer being eligible or not completing the renewal process. Nearly half of the respondents said they had never even been through the renewal process before, which is understandable considering people haven\u2019t had to go through it in three years.<\/p>\n\n\n\n
\u201cThe KFF data was, I think, alarming, but not particularly surprising given this has been the concern that a lot of policymakers have had throughout this,\u201d Louise Norris, policy analyst for HealthInsurance.org, told The Hill. \u201cWe\u2019ve known for a long time that this is eventually going to happen, especially throughout this part of this year.\u201d<\/p>\n\n\n\n
States have been given until May 2024 to complete the \u201cunwinding\u201d process of unenrolling people who are no longer eligible for Medicaid coverage.<\/p>\n\n\n\n
An earlier survey from KFF estimated that up to 17 million people could lose coverage with the termination of COVID-19 measures.<\/p>\n\n\n\n
Many will lose coverage due to no longer being eligible, but others stand to become uninsured due to \u201cadministrative churn,\u201d a term federal agencies use to refer to clerical issues that prevent people from receiving services. These obstacles include changes of address, insufficient contact information or enrollees simply struggling with the renewal process.<\/p>\n\n\n\n
Joan Alker, director of the Center for Children and Families at the Georgetown McCourt School of Public Policy, said she has observed high rates of \u201cprocedural denials\u201d in some states, meaning people were denied coverage due to not completing the renewal process, not because they were ineligible.<\/p>\n\n\n\n
\u201cWe\u2019ve seen three states, at least in the first round of data, that their procedural denial rate was over 80 percent: Arkansas, Florida and Indiana,\u201d Alker said. \u201cIf a governor sees that high procedural denial rate, in my opinion, they should pause the process and see what\u2019s going wrong.\u201d<\/p>\n\n\n\n
With many individuals losing coverage regardless of their eligibility, stakeholders want people to know their options going forward. Norris pointed out three viable options for most people who lose coverage during the unwinding period.<\/p>\n\n\n\n
The majority of those who are no longer eligible for Medicaid coverage should be up for an employer health plan. These individuals may qualify for a special enrollment period of 60 days after their Medicaid coverage ends.<\/p>\n\n\n\n
Some people aged into Medicare eligibility during the course of the pandemic and have yet to transition to the separate federal health insurance program for seniors. Such individuals have been given six months to transition from Medicaid to Medicare without incurring late enrollment penalties.<\/p>\n\n\n\n
People who don\u2019t have access to either Medicaid or employer coverage can also look into getting coverage through HealthCare.gov, with many states offering special enrollment periods as well.<\/p>\n\n\n\n
Alker stressed that parents should be aware their children are likely still eligible for coverage under the Children\u2019s Health Insurance Program (CHIP). An earlier projection from Georgetown estimated that up to 6.7 million children could lose Medicaid coverage as eligibility is reassessed.<\/p>\n\n\n\n
\u201cI think one really important message, from my perspective, is that parents need to know that their children are probably still eligible,\u201d said Alker. \u201cAnd so they may be on a different path from their children. And over half the children in the country now are insured through Medicaid. This is of enormous consequence for children.\u201d<\/p>\n\n\n\n
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Uninsured rates in the U.S. have reached record lows thanks in part to the temporary measure enacted during the pandemic. Even in an ideal situation with extensive outreach, large numbers of people are expected to lose their coverage, turning back some of the progress that has been made.<\/p>\n\n\n\n
The Congressional Budget Office released a report estimating that 15.5 million people will leave Medicaid during the 18-month unwinding period, and 6.2 million of those people will become uninsured.<\/p>\n\n\n\n
\u201cObviously in an ideal world, all these folks who transition off of Medicaid will transition to one of those other categories of coverage, but I think policymakers understand that it\u2019s unrealistic to expect that to be universal,\u201d Norris said. \u201cSome folks are going to become uninsured despite policymakers\u2019 best efforts. How much it changes, I think, remains to be seen.\u201d<\/p>\n\n\n\n