Nov 17, 2022 - Health

Study: Most Medicaid enrollees unprepared for safety net redeterminations

Illustration of a safety net with a hole in it.  

Illustration: Aïda Amer/Axios

Millions of Medicaid recipients are unaware that states will redetermine their eligibility for the program when the COVID-19 public health emergency ends — and fewer than one third know what other coverage options exist, according to an Urban Institute policy brief.

The big picture: Researchers say the onus is on state Medicaid agencies to increase outreach and simplify renewal processes to avoid unnecessary coverage losses.

Be smart: Temporary pandemic-era reforms that Congress passed in 2020 increased the share of federal Medicaid spending if states offered continuous coverage to enrollees, suspending the program's usual churn.

  • Those policies will end when the public health emergency expires, as soon as April, potentially ushering in a spike in the uninsured rate.
  • The loss of Medicaid coverage qualifies people to enroll in the federal marketplace for 2023 coverage past the Jan. 15 deadline.
  • But an August report from HHS found most Medicaid enrollees who get stuck in the churn aren't able to enter the marketplace or get employer-based insurance.

Nearly 80% of respondents the Urban Institute surveyed said they weren't told how to navigate the process.

  • More than 60% overall had heard "nothing at all" about the Medicaid redeterminations.
  • The most common sources of information were news outlets or social media — not Medicaid agencies.

By the numbers: Close to 90 million people are enrolled in Medicaid and CHIP in the U.S., per CMS’ latest numbers. The Kaiser Family Foundation projects up to 15 million could lose coverage upon the emergency ending, regardless of eligibility.

  • Less than a third of those projected to lose eligibility could qualify for marketplace premium tax credits, per HHS.
  • Latinos are expected to incur the greatest loss, according to the HHS report, with nearly a third of Latino kids and young adults enrolled in Medicaid or CHIP slated to lose coverage.
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