What you can do to protect coverage for yourself or someone you love.
Health Care is expensive. According to the US Centers for Medicare and Medicaid Services, US healthcare spending reached $4.3 trillion in 2021. That makes healthcare spending 18.3% of the US Gross Domestic Product. So, it is not surprising that states have started removing Medicaid coverage for many of their residents.
During the Public Health Emergency (PHE), the federal government barred states from kicking Medicaid recipients off the program, even if they started making too much money to qualify for Medicaid. The federal government gave states more money to help cover the cost. The Consolidated Appropriations Act ends Medicaid continuous enrollment starting April 1, 2023. This means each state’s Medicaid process reverts to pre-pandemic rules.
At first thought, this seems reasonable. Each state will enforce its process for qualifying for Medicaid, just as it did before the pandemic. The unreasonable part of this is that many people who need and qualify for this coverage will lose it.
Who Might Lose Coverage?
Possibly 2 million people living in the 11 states that have not adopted the ACA Medicaid expansion fall into the “coverage gap.” These individuals do not qualify for Medicaid (as their income exceeds Medicaid eligibility limits in their respective states) but have incomes below poverty, making them ineligible for premium subsidies in the ACA Marketplace.
Many millions more may lose their coverage because of procedures. People who qualify for Medicaid coverage will lose it if they do not fill out and return their forms in the allotted time. Again, this may seem reasonable. People should just fill out the forms and return them. It is not that easy for everyone, though. Medicaid serves the elderly, disabled, and low-income people in this country. The people we should be protecting. These groups may have more problems filling out the forms, receiving the forms, or knowing how to protect themselves.
About 84 million people received health care through Medicaid, and about 15 million may lose access soon. States will now be required to check Medicaid eligibility. In Michigan, where I live, they will do this slowly. States are required to check eligibility within one year, but in Arizona, Arkansas, Florida, Idaho, Iowa, New Hampshire, Ohio, Oklahoma, and West Virginia, are moving quicker and will begin now. This rush can easily lead to the mass removal of people who need this health care coverage.
What To Do?
- States must mail a renewal form to the address they have on record. Be sure your address is correct. States must try to contact you by phone, text, or email, besides mailing. They administer Medicaid at the state level, so each state has its own office that handles Medicaid. If you don’t know who to contact, try checking your state’s Department of Health and Human Services or Office of Medicaid or use the interactive tool here.. If the state sends the paperwork to the address, they have on file and they send an electronic message; they have met its burden. They have no obligation to make sure you receive the paperwork.
- You MUST fill out the forms and return them by the date they give you, which should be 30 days. Whatever they send you, you must fill out and return it. If you don’t understand something on the forms, call the number on the paperwork for help. If you don’t return the paperwork, they can remove your eligibility.
- If you are no longer eligible, there will be a special ACA “marketplace” open enrollment period from March 31, 2023, through July 31, 2024. If you lose coverage, you have 60 days to enroll in the marketplace. In most states, you should receive a subsidy for this coverage.
- Children may still qualify even if parents don’t. If your child has Medicaid, they probably won’t be affected. Be sure to check their enrollment, it does not have to be the same as yours.
- If you receive Medicaid because you qualify for SSI, you will still qualify. Remember, if you are in a state where enrollment in Medicaid is NOT automatic, you may need to apply again, but you will still qualify.
This program serves a vulnerable population and states should go above and beyond to make sure everyone who qualifies receives coverage. Unfortunately, that is not how it will play out. If you, someone you love, or someone you serve receives Medicaid, make sure they stay enrolled.