WASHINGTON (AP) — If you get health care coverage through
Medicaid, you might be at risk of losing that coverage over the
next year.
Roughly 84 million people are covered by the government-
sponsored program, which has grown by 20 million people since
January 2020, just before the COVID-19 pandemic hit.
But as states begin checking everyone’s eligibility for Medicaid
for the first time in three years, as many as 14 million people
could lose access to that health care coverage.
A look at why so many people may no longer qualify for the
Medicaid program over the next year and what you need to know if
you’re one of those people who relies on the program.
WHAT’S HAPPENING TO MEDICAID?
At the beginning of the pandemic, the federal government
prohibited states from kicking people off Medicaid, even if they
were no longer eligible. Before the pandemic, people would
regularly lose their Medicaid coverage if they started making
too much money to qualify for the program, gained health care
coverage through their employer or moved into a new state.
That all stopped once COVID-19 started spreading across the
country.
Over the next year, states will be required to start checking
the eligibility again of every person who is on Medicaid. People
will have to fill out forms to verify their personal
information, including address, income and household size.
WHEN MIGHT I LOSE MY COVERAGE?
That will vary depending on which state you live in; some states
are moving faster than others to check eligibility. Arizona,
Arkansas, Florida, Idaho, Iowa, New Hampshire, Ohio, Oklahoma
and West Virginia are among the states that will begin removing
ineligible Medicaid recipients as early as April.
Other states will start taking that step in May, June or July.
Not everyone will be removed from the program all at once.
States plan to verify all recipients’ eligibility over periods
of nine months to one year.
___
HOW WILL I BE NOTIFIED IF I’M LOSING COVERAGE?
If you rely on Medicaid for care, it’s important to update your
contact information, including home address, phone number and
email with the state from which you receive benefits.
States will mail a renewal form to your home. The federal
government also requires states to contact you in another way -–
by phone, text message or email –- to remind you to fill out the
form.
Even if mailed notices reach the right address, they can be set
aside and forgotten, said Kate McEvoy, executive director of the
nonprofit National Association of Medicaid Directors.
“A text might just grab someone’s attention in a way that would
be more accessible,” she said, noting that a quick message also
may be less intimidating than a mailed notice.
Most states have already used texting for things such as
reminding patients to get a COVID-19 vaccine or about upcoming
doctor’s visits. But sending mass texts on Medicaid eligibility
will be new, McEvoy said.
You will have at least 30 days to fill out the form. If you do
not fill out the form, states will be able to remove you from
Medicaid.
___
WHAT ARE MY OPTIONS IF I’M KICKED OFF MEDICAID?
Many people who will no longer qualify for Medicaid coverage can
turn to the Affordable Care Act’s marketplace for coverage,
where they’ll find health care coverage options that may cost
less than $10 a month.
But the coverage available on the marketplace will still be
vastly different from what’s offered through Medicaid. Out-of-
pocket expenses and co-pays are often higher. Also, people will
need to check if the insurance plans offered through the
marketplace will still cover their doctors.
A special enrollment period will open for people who are
unenrolled from Medicaid that will start on March 31 and last
through July 31, 2024. People who lose Medicaid coverage will
have up to 60 days to enroll after losing coverage, according to
guidance the Centers for Medicare and Medicaid Services sent to
states last month.
___
MY CHILDREN ARE ENROLLED IN MEDICAID. WHAT WILL HAPPEN TO THEIR
COVERAGE?
More than half of U.S. children receive health care coverage
through Medicaid or the Children’s Health Insurance Program.
Even if you receive a notice that you’re no longer eligible for
Medicaid, it’s likely that your child still qualifies for the
program or for health care coverage through CHIP, which covers
children whose families make too much money qualify for Medicaid
but don’t earn enough to afford private health insurance.
Between 80% and 90% percent of children will still be eligible
for those programs, according to estimates from the Georgetown
University Health Policy Institute’s Center for Children and
Families.
“When a parent receives a message that they aren’t eligible
anymore, they often assume their child is no longer eligible
either,” said Joan Alker, the center’s executive director. “It’s
more common to find that the parent is no longer eligible for
Medicaid, but the child still is.”
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