Since March of 2020, when the COVID-19relief package passed, Medicaid enrollment has skyrocketed to a record 90 million people and since then, no one has been kicked off.
Now, about 15 million people could be dropped from Medicaid when the continuous enrollment requirement ends this spring, with 7 million of whom could still be eligible but may fall through the cracks, according to the U.S. Department of Health and Human Services.
To put it simply, COVID-19 emergency orders banned states from kicking people off Medicaid starting in 2020, but this spring, that ends, and the responsibility of redetermination and disenrollment is put in the hands of states.
As a Medicaid recipient, people like Seth Watkins say they know how important this coverage is to receiving life-saving treatment and medication."I would be paying out-of-pocket money that I probably don't have to spend on medical bills," Watkins said. "I wouldn't be able to afford my medications, like all my medications, for my diabetes and my psychiatric medications and my HIV medications."
He worries about everyone who is at risk of losing coverage.
"I'm afraid for people that have no coverage. I'm afraid for people from other countries like refugees and people that speak other languages that don't know how to interpret the redetermination process," Watkins said.
Gretchen McGinnis is the senior VP of Healthcare Systems and Accountable Care for Colorado Access, the last nonprofit health plan in the state of Colorado.
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By the government's last count in 2021, 64 million adults were enrolled in Medicare. But that doesn't mean it's simple to navigate.
"The thing that's helpful in this process if it's not happening all at once and so we're talking about a 14-month wave of this," McGinnis said.
The first thing to understand is that your redetermination date is based on your enrollment time period. That's when the state conducts a review of your eligibility requirements.
"And you won't get information until two months before your redetermination date, so I think there will be some anxiety for folks who may think they are losing coverage, but their redetermination date may not be until November," McGinnis said.
Secondly, she says, anyone on Medicaid needs to make sure their address is up to date because redetermination packets are sent through US mail.
"Keeping that updated is of the utmost importance and update it every time it changes," McGinnis said. "As often as the state can, or states can nationally, they are going to try to validate a member's eligibility without them doing anything."
McGinnis explains there will be a portion of people that sail through approval because they provided income verification through a job application or other means. She also points out that states are partnering collaboratively with health care exchanges to provide other options. That is a service available in every state that helps people shop for and enroll in affordable medical insurance.
"That can be another avenue for coverage for folks who are likely going to continue to be on that end of earning too much to qualify for Medicaid," McGinnis said.
With 90 million Americans and snail mail involved, this isn't going to be a simple process experts say. They stress that no matter where you are in the country, there are people and case managers that can help you navigate it.
