Why are enrollees losing Medicaid coverage?
In 2020, Congress established the Families First Coronavirus Response Act (FFCRA) to allow a continuous enrollment provision helping people with medical coverage during the pandemic. For three years, the federal government instructed states to maintain enrollment of nearly all Medicaid and Children’s Health Insurance Program (CHIP) enrollees regardless of their eligibility requirements. If states wanted to receive enhanced federal funding, they needed to offer this provision until the end of the month when the public health emergency ended. The Consolidated Appropriations Act of 2023 separates the continuous enrollment from the public health emergency and will allow disenrolling after March 31, 2023. As states begin to unwind Medicaid by terminating coverage, potentially millions of people will need to find new health insurance.
How soon will people lose Medicaid/CHIP coverage?
Before March 2020, states needed to examine each enrollee’s eligibility at least once a year. Then they disenrolled those who no longer qualified. On April 1, 2023, states will have 12 months to assess the eligibility of Medicaid enrollees from the last three years. Many states have maintained their regular Medicaid eligibility redetermination processes throughout the public health emergency but have not disenrolled anyone. So, the disenrolling of ineligible people could occur much faster than expected. Every state’s eligibility requirements are different. The Kaiser Family Foundation estimates that between 5.3 million and 14.2 million people will lose Medicaid coverage over the 12-month unwinding period.
What if I am still eligible? Can I lose coverage?
Some people might experience a gap in Medicaid coverage even though they remain eligible for the program. People most at risk include those who have moved since 2020, individuals with disabilities, and those with limited English proficiency (LEP). If enrollees have moved and not updated their contact information with the state Medicaid agency, they may not have received renewal notices at their new address. States are encouraging Medicaid enrollees to swiftly respond to renewal notices to ensure their information is updated. People with disabilities, such as those needing large print or Braille to understand documents, have a greater chance of missing critical updates and announcements from Medicaid because not all states support these document formats online. Most states offer online Medicaid documents in Spanish, but only some offer other language options, and others only provide online documents in English.
Who is eligible for Medicaid/CHIP?
Medicaid coverage can encompass many groups of people. Groups that may qualify include low-income families, people with disabilities, pregnant women and their children, those receiving Supplemental Security Income, and more. The Children’s Health Insurance Program offers “health coverage to uninsured children in families with incomes too high to qualify for Medicaid, but too low to afford private coverage.”
If Medicaid/CHIP disenrolls me, what can I do?
Anytime throughout the year, you can submit a re-enrollment application for Medicaid or CHIP and see if you qualify. Losing your Medicaid coverage is a qualifying life event and allows you to participate in a Special Enrollment Period. Medicare plans will allow you a three-month Special Enrollment Period to acquire new coverage. ACA products will provide a Special Enrollment Period with a 60-day window. Additionally, “Congress extended enhanced subsidies for the ACA marketplace, which were first included in the American Rescue Plan Act (ARPA) during the pandemic, making those plans more affordable through 2025.” If you find yourself without health insurance, Empower Brokerage has friendly licensed agents that can assist you in finding the right coverage for you.
Please call 888-446-9157 to learn more.
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