Over 1 Million People Lose Medicaid Coverage Amid Pandemic’s End
More than 1 million people have been removed from Medicaid in the last two months, as some states swiftly terminated healthcare coverage following the conclusion of the coronavirus pandemic.
Concerns Over State Reassessment of Medicaid Eligibility
While the federal government mandates eligibility reviews, the Biden administration is expressing dissatisfaction with the approach taken by certain states.
State Reassessment of Medicaid Eligibility is a Frustrating Experience
“Pushing things and rushing things will cause eligible people (children and families) to lose coverage for a period of time,” warned Daniel Tsai, a senior federal Medicaid official.
About 1.5 million people have already been removed from Medicaid in more than two dozen states that initiated the reassessment process in April or May, according to reports and data obtained by the Associated Press.
Florida has seen the largest drop, with several hundred thousand people losing coverage. Other states, such as Arkansas, Idaho, Kansas, Nevada, New Hampshire, Oklahoma, South Dakota, Utah, and West Virginia, have also experienced high dropout rates.
Arkansas alone has removed over 140,000 people from Medicaid.
Eligibility reassessments have caused headaches for individuals like Jennifer Mojica, who was mistakenly deemed ineligible due to an error in Arkansas’ determination of her income. Mojica’s 5-year-old son was also at risk of being disenrolled, despite her never requesting it. While she managed to reinstate her son’s coverage, her husband’s eligibility is now in question.
Arkansas officials claim they have made efforts to auto-renew coverage for as many people as possible, with a focus on families with children. However, a state law requires post-pandemic eligibility reassessments to be completed within six months, and the Department of Human Services stated that individuals no longer eligible will be promptly disenrolled.
Arkansas Governor Sarah Huckabee Sanders defended the state’s process, stating that those who don’t qualify for Medicaid are taking resources away from those in need.
Many More People at Risk of Losing Medicaid Coverage
As of February, over 93 million people were enrolled in Medicaid, a significant increase from pre-pandemic levels. Now that eligibility reviews have resumed, states are examining a backlog of cases to determine if individuals’ circumstances have changed. However, tracking responses has proven challenging, with people moving, changing contact information, or ignoring renewal notifications.
States like Florida have made multiple attempts to contact individuals before disenrolling them, but a significant number of people have not responded. Retroactive reinstatement of coverage is possible if individuals provide proof of eligibility within 90 days of the deadline.
Unlike some states, Idaho continued to assess Medicaid eligibility during the pandemic but did not remove anyone. However, since April, Idaho has processed cases and removed nearly 67,000 out of 92,000 individuals whose cases have been decided so far.
Advocates express concerns that many households losing coverage may include eligible children, as Medicaid covers children with higher income thresholds than their parents or guardians. Unfortunately, the Centers for Medicare and Medicaid Services (CMS) does not require states to report demographic breakdowns of disenrolled individuals, making it difficult to confirm the impact on children.
Medicaid Recipients Criticize Flawed System
Recipients like Julie Talamo from Florida describe the arduous process of trying to maintain Medicaid coverage for their loved ones. Talamo spent hours on hold, trying to ensure her son with special needs continued to receive Medicaid. Some states have struggled to complete eligibility determinations each month, leading to incomplete cases and potential delays in processing renewals.
Advocates and experts worry that the backlog of unprocessed data will only worsen over time, making it challenging for states to catch up. This leaves individuals like Gary Rush from Pittsburgh uncertain about their future healthcare coverage, while others, like Samantha Richards from Indiana, remain anxious about potential disruptions to their Medicaid coverage.
It is estimated that over 15 million people will lose Medicaid coverage once the medical emergency caused by the coronavirus officially ends.
More than 1 million people have been removed from Medicaid in the last two months as certain states terminated healthcare coverage following the end of the pandemic. The Biden administration is expressing concern over the approach taken by these states regarding the reassessment of Medicaid eligibility. Reports and data show that about 1.5 million people have already been removed from Medicaid in over two dozen states that initiated the reassessment process. States like Florida, Arkansas, Idaho, Kansas, Nevada, New Hampshire, Oklahoma, South Dakota, Utah, and West Virginia have experienced high dropout rates. The eligibility reassessments have caused issues for individuals who were mistakenly deemed ineligible or had their eligibility questioned. Arkansas officials claim that efforts have been made to auto-renew coverage for as many people as possible, but those who no longer qualify will be disenrolled promptly. The state’s Governor defended the process, stating that those who don’t qualify are taking resources away from those in need. With eligibility reviews resuming, states are examining a backlog of cases to determine if circumstances have changed. However, tracking responses has proven challenging due to people moving, changing contact information, or ignoring renewal notifications.
What steps should be taken to ensure that individuals who are mistakenly deemed ineligible for Medicaid are not disenrolled from healthcare coverage?
To ensure that individuals who are mistakenly deemed ineligible for Medicaid are not disenrolled from healthcare coverage, the following steps can be taken:
1. Clear and Transparent Eligibility Criteria: Establish and communicate clear guidelines for Medicaid eligibility criteria to avoid misunderstandings and misinterpretations.
2. Prompt and Thorough Application Processing: Ensure that applications for Medicaid are processed promptly and thoroughly, with diligent review of all relevant documents and information.
3. Robust and Effective Verification Process: Employ a robust verification process that cross-checks the applicant’s information with various databases, such as income, residency, and social security, to minimize errors and identify potential discrepancies.
4. Enhanced Training for Staff: Provide comprehensive and ongoing training to Medicaid eligibility staff to accurately interpret and apply the eligibility rules, reducing the likelihood of making mistakes in determining eligibility.
5. Improved Communication Channels: Establish clear and effective channels of communication between applicants, Medicaid agencies, and healthcare providers to promptly address any eligibility issues or discrepancies, ensuring timely resolution and preventing unwarranted disenrollment.
6. Error Reporting and Resolution Mechanisms: Implement a structured system to track, report, and resolve eligibility errors or mistakes promptly. This may include regular audits, customer feedback mechanisms, and internal mechanisms to identify and rectify errors efficiently.
7. Appeals and Redetermination Process: Develop a user-friendly and accessible appeals process, allowing individuals who have been mistakenly deemed ineligible to contest the decision and provide additional evidence for reconsideration of their eligibility status.
8. Collaboration with Community Organizations: Partner with community-based organizations, healthcare providers, and advocacy groups to identify and assist individuals who may be at risk of wrongful disenrollment, ensuring adequate support and guidance throughout the eligibility process.
9. Continuous Improvement and Evaluation: Regularly assess and evaluate the eligibility determination process to identify areas for improvement, address systemic issues, and prevent similar mistakes from occurring in the future.
By implementing these steps, Medicaid agencies can minimize the chances of mistakenly deeming individuals as ineligible and provide better assurance that eligible individuals will not be unjustly disenrolled from their healthcare coverage.
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1 comment
It’s disheartening to see millions of people being dropped from Medicaid during this critical time. Access to healthcare is a basic necessity, particularly during a pandemic. We must prioritize government assistance and support to ensure that no one gets left behind in times of crisis.