How Ending Continuous Enrollment in Medicaid Can Affect You
As of November 2022, almost 92 million people were enrolled in Medicaid and CHIP, the highest number on record and up nearly 30% since February 2020. This is largely due to the fact that during the public health emergency (PHE) due to COVID-19, state Medicaid agencies could receive additional federal reimbursement money if they did not end someone’s coverage. But that requirement ends on April 1, and it could result in millions of people losing their health insurance.
The practice of not ending coverage is officially called “continuous enrollment” and has prevented people from losing their coverage during the pandemic for ordinary (also income-related) reasons. For many people who lost their jobs during the pandemic and subsequently ended up on Medicaid, this meant they would remain insured unless they left the state or voluntarily ended their coverage, even if they started making more money than the rules allow. acceptability. Typically, state Medicaid agencies have responded to the continuous enrollment requirement by completely suspending the review, renewal, and termination processes.
All this will soon come to an end. PHE COVID-19 officially ends May 11, but the 2023 Congressional Spending Bill allows states to start phasing out continuous enrollment about six weeks earlier on April 1. There are more than three years of audits to go through, during which agencies have seen their highest enrollment rates – that will clearly take some time. To help spread the workload, Medicaid agencies have 12 months to initiate an extension and 14 months to complete it .
So what does this mean for the approximately 92 million people currently insured through Medicaid? It all depends on what state you live in and how they deal with this “roll-up” process. Medicaid eligibility is usually reviewed every year, but with so much COVID backlog and a minimum 12-14 month roll-out period on the table, the timelines are a bit longer than normal. Here’s what to keep in mind when continuous enrollment comes to an end.
The first step is not to panic. You don’t really have to do anything – your only responsibility is to know the deadlines and be prepared to verify your income. If your income hasn’t changed since you filed and the state can verify it electronically, you’ll get a new eligibility notice in the mail, and that’s it. you will be installed for one more year. If they cannot, you will receive a notification in the mail with a formal request for information. They generally must notify you at least 60 days prior to the renewal date and you will have 30 days to respond with more information. (And if you’re not currently eligible, don’t panic just yet—some states are creating “interim programs” to reach people who aren’t eligible.)
But the nasty little secret of Medicaid layoffs is that they don’t always happen for eligibility reasons. Many eligible people lose their benefits every year due to “churn,” when documents get lost in the mail or returned to sender, phone lines take too long, and administrative red tape usually keeps people from communicating with the government. To prevent this from happening to you, make sure you don’t miss important messages:
- Keep an eye on your mail: the most important notifications will come in the mail, so stay tuned. (And if you’ve moved, make sure your government office has the correct address.)
- Leave space in your voicemail inbox: You don’t have to start taking calls from unknown numbers – just make sure important numbers can leave you a message.
- Keep an eye on texts: Many states add text messages to their contact options to speed up the process during the spin-up period, so if you’re the type to ignore texts from unfamiliar numbers, at least skim them to see if there are any. or Medicaid messages.
- Check your spam folder. Unfortunately, government agencies don’t always know how to protect their emails from spam filters.
Bottom line: If you or someone in your household received Medicaid or CHIP during the pandemic, expect to reevaluate your eligibility between April 1, 2023 and April 1, 2024. You only need to worry about losing coverage when if your circumstances have changed since you filed and your current income is above the Medicaid ceiling. Even if it isn’t, be prepared to verify your income just in case. No news is good news; your coverage cannot be terminated without notice.