States are preparing to remove millions of people from Medicaid as protections installed early in the COVID-19 pandemic expire. The phase-out will hit low-income Americans hard.
The upheaval, which begins in April, will put millions of low-income Americans at risk of losing health coverage, threatening their access to care and potentially exposing them to large medical bills.
Even before the pandemic, states struggled to stay in contact with Medicaid recipients, who in some cases lack a stable address or internet service, do not speak English, or don’t prioritize health insurance over more pressing needs. Ordinarily, people move in and out of Medicaid all the time. States, which have significant flexibility in how they run their Medicaid programs, typically experience significant"churn" as people’s incomes change and they gain or lose eligibility.People who lose Medicaid coverage — in the more than 30 states covered by the federal marketplace — will have until July 31, 2024, to sign up for Affordable Care Act coverage, the Centers for Medicare and Medicaid Services announced Jan. 27.
In an all-hands-on-deck effort, states are enlisting Medicaid health plans, doctors, hospitals, state insurance marketplaces, and an assortment of nonprofit groups, including schools and churches, to reach out to people at risk of losing coverage. said in November. At least 1 in 4 letters sent to enrollees were returned on account of a wrong address.The law that allows states to begin disenrolling ineligible Medicaid recipients on April 1 bars states from disenrolling anyone because mail was returned as undeliverable until the state has made a"good faith effort" to contact the person at least one other way, such as by phone or email.
States have until February to submit their unwinding plans to the federal Centers for Medicare and Medicaid Services, which will monitor the process.Oregon plans to allow children to stay on Medicaid until age 6 and allow everyone else up to two years of eligibility regardless of changes in income and without having to reapply. No other state provides more than one year of guaranteed eligibility.
Another concern for advocates is that Florida makes less use of government databases than other states to check enrollees’ incomes."We make everyone jump through hoops to get reenrolled instead of utilizing all the acceptable data," Ray said.
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