As pandemic protections expire, states are redetermining which people are eligible for the health insurance program.
Throughout the pandemic, millions of Americans on Medicaid have been shielded from losing health care coverage. Medicaid provides health coverage for low-income Americans; for the past three years, states suspended their typical process of redetermining whether someone remained eligible for coverage.
States must now reverify that every Medicaid recipient still qualifies for the program within the next 14 months.
Many people will continue the same Medicaid coverage they’ve had for years, but millions could lose access to their current coverage — either because they don’t qualify for Medicaid anymore, or even if they do continue to qualify, because the administrative hurdles to renew their coverage are so high. In particular, people with disabilities, people who are not native English speakers and people who changed addresses during the pandemic may struggle to wade through the red tape, said Lindsay Allen, a health economist and Medicaid policy researcher at Northwestern Medicine.
States can begin the process of disenrolling people who are not eligible on April 1, and they have 14 months from that date to complete the redetermination process, with people losing coverage intermittently throughout. Each state will have a slightly different process, and most will take a full year to work their way through every Medicaid enrollee.
“There’s 92 million people in our country that need to fill out paperwork all at once, in a very confined amount of time,” said Dr. Jose Francisco Figueroa, an assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health.
Who will be affected?
Some people will get kicked off Medicaid because they make significantly more income than they previously did. Some health policy experts are worried about those who remain eligible but don’t have the time or resources to complete what can be a cumbersome renewal process.
“We’re worried that many people, when they go try to schedule an appointment with their doctor, somebody’s going to tell them, ‘Oh, you don’t have insurance anymore,’” Dr. Figueroa said.
If you have moved, your current state’s Medicaid program may have a harder time reaching you.
“We know whenever these sorts of moments happen, it’s people of color, it’s kids, it’s people that don’t speak English that are always hit the hardest,” said Natalie Davis, a founder and the chief executive of United States of Care, a nonpartisan advocacy organization that supports expanding access to health care.
How can you prepare?
It’s critical to make sure your contact information is up-to-date with your state Medicaid office. In many states, you can create an account on your state Medicaid website, where you can verify that your information is accurate and update your communication preferences. And you can always locate the phone number of your state’s Medicaid office to call and confirm, although call centers may be particularly bogged down during this period.
Watch for communication from your state Medicaid office — notices in the mail, phone calls, emails. Some states have already begun contacting people to inform them about the renewal process.
While all states must begin contacting enrollees by April, most people won’t receive this renewal notice for months, said Jennifer Tolbert, an associate director of the Program on Medicaid and the Uninsured at the Kaiser Family Foundation. “I do worry that there’s all this urgency around April 1 and when nothing big happens in April that everyone just breathes this big sigh of relief and says, ‘Oh, I’m fine, I don’t have to worry about this.’ But that’s not going to be the case.”
Different states may require different documentation, but in general, they will want to verify your income, address and whether you’ve had a change in the number of dependents, said Ms. Davis. You may receive a notice asking to confirm or update your financial or other information; people typically are given 30 days to respond, Ms. Tolbert said.
“Everyone who’s on Medicaid today: Expect to fill out paperwork,” Dr. Figueroa said.
What should you do if you lose Medicaid coverage?
If you’re notified that your Medicaid coverage has been terminated but you think you continue to qualify, the first thing you should do is find out if you lost coverage inappropriately, Ms. Tolbert said. Contact your state Medicaid office — although keep in mind that call centers are likely be swarmed, she advised.
“Don’t give up if you can’t get through via the phone,” she said. “Stick with it.” You can request what’s known as a fair hearing process, to appeal the state’s decision to terminate your Medicaid benefits.
You can find a directory of organizations that can help you navigate Medicaid renewal at Localhelp.healthcare.gov.
What are the options if I’m no longer eligible for Medicaid?
If you are no longer eligible for Medicaid, your best bet is to seek out subsidized insurance by going to the online Affordable Care Act marketplaces either operated by your state or available at HealthCare.gov. The American Rescue Plan expanded insurance subsidies, so people who lose access to Medicaid may still be able to find an affordable plan, Ms. Tolbert said. But some people in the 10 states that have not previously expanded Medicaid will be left in a coverage gap, she said, not eligible for subsidized insurance but also unable to qualify for Medicaid.
If you are employed, you may be able to get coverage from your employer. Reach out to your H.R. department within 60 days of losing coverage — the sooner, the better — to ask about coverage. If you’re married, your spouse may want to ask their employer about potential coverage options that can apply to you; if you’re an adult under the age of 26, you may also be able to switch to your parents’ insurance.
And if you’re a parent, just because you’ve lost coverage doesn’t always mean your child will. Any notification that you’re no longer eligible for Medicaid should explain if your child retains coverage, Ms. Tolbert said — but if you’re unsure of your child’s status, get in touch with your state Medicaid office.
It’s the compounding weight of these intricacies — uncertainty over which plan covers which family member, confusion over what information someone needs to qualify for Medicaid — that policy experts worry will further burden Medicaid recipients. The extra stress of redetermination adds a “mental tax,” Ms. Davis said.
But as the redetermination process kicks off, tracking down contact information for state agencies you can turn to in advance and watching for important communications can help you prepare. “If you’re proactive, you can minimize the chance of a gap in your coverage,” Dr. Allen said.
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