Medicaid coverage increased during the COVID-19[feminine[feminine pandemic, with nearly one in four Americans covered by the low-income health insurance plan. But up to 15 million people may be at risk of losing coverage this year as a pandemic rule runs out.
Prior to the public health crisis, U.S. states periodically reviewed the eligibility of Medicaid recipients to verify that they were still eligible for coverage based on requirements such as state residency and income. The latter varies by state, but is typically around 138% of the federal poverty rate. For example, a single person in California cannot earn more than $ 17,609 a year to qualify.
But during the pandemic, a provision in the Families First Coronavirus Response Act hit the pause button on these eligibility status checks, ensuring continued Medicaid coverage for recipients during the pandemic. As millions lost their jobs and often their health insurance, many signed up for Medicaid coverage. This helped increase program records to a record 76.7 million recipients in July 2021 (the most recent data available), a 19% jump from 2019.
This pause in the eligibility status check process will end as early as April, which could lead to up to 15 million people leaving Medicaid, according to an analysis by Matthew Buettgens, a senior member of the Urban Institute. The problem is that some low-income people may lose coverage simply by falling into the cracks, such as not knowing that they need to provide income verification to continue their coverage under the federal program.
“There are states that process an unprecedented number of participants in a fairly limited period of time,” Buettgens told CBS MoneyWatch. “There is a lot of concern that this could lead to more unnecessary cancellations of people who are still eligible.”
Two hours of waiting by phone
Some health advocates are concerned about the ability of states to handle eligibility checks for a record number of enrollees at a time when agency staffing levels may be low, either because of the shortage of labor force or state budget cuts. For example, Texas, which added 1 million Medicaid enrollees during the pandemic, has cut staff in its Medicaid division, according to the Houston Chronicle.
“We are very concerned that many people do not know that they have to enroll. And if they do, will the state process them in a timely manner?” said Jana Eubank, executive director of the Texas Community Health Centers Association.
In addition, updating eligibility requirements can be time consuming for Medicaid recipients, he added. Enrollees who have not logged in to the online system to update their information may have forgotten their password, while the Texas system does not allow people to retrieve forgotten passwords electronically, Eubank noted.
“You have to call 211 to be able to reset your password, and in some cases we are listening to patients who have to wait two hours to reset their passwords,” he said, referring to the social service hotline for state of Texas.
“Unprecedented situation”
Medicaid enrollment had been declining before the pandemic, and enrollment fell 3 percent from December 2017 to December 2019, according to the Kaiser Family Foundation. This was due in part to the growing U.S. economy during this period, according to the analysis.
But this trend was reversed with the pandemic. As the economy collapsed and millions lost their jobs, lawmakers added a provision to the Family Coronavirus Response Act (FFCRA) that offered states more Medicaid funding in exchange for enrollment. continuous during the public health emergency.
Despite the fall before the pandemic, Medicaid enrollment had been growing for decades. For example, the number of people enrolled in 2000 was 34.5 million, less than half of the current enrollment in the program, according to the Medicaid and CHIP Payment and Access Commission. And that has resulted in higher spending, with program spending more than tripling, from $ 206 billion to $ 683 billion in 2020.
In January, the Biden administration formally extended for 90 days its finding that the U.S. is facing a public health emergency. Without further ado, Medicaid’s global relief will end in mid-April. This means that states will have to resume eligibility status checks even in the midst of the recipient jump.
States “will have to determine eligibility for a larger population than they have ever had, and potentially very quickly,” Buettgens said.
Another question is what will happen to the 15 million people who are likely to lose coverage this year if eligibility status checks are resumed. Buettgens ’analysis found that about a third will be eligible for subsidized private healthcare in the online markets under the Affordable Care Act. It is likely that almost everyone else will receive health care through their employer, especially given the improved labor market, with employers increasing their profits to attract workers.
But these families will pay more for health coverage through premiums and out-of-pocket costs, according to the analysis. The risks are that these households may choose to turn off health coverage due to higher costs or otherwise go through cracks so as not to keep track of their eligibility status check, experts said. .
“If people don’t sign up for alternative forms of coverage, either because they don’t know what they’re eligible for or because they think it’s too expensive, that could lead to an increase in people without insurance,” Buettgens said. “It’s a completely unprecedented situation: there’s a lot of uncertainty.”
- In:
- health care
Add Comment