Minneapolis, MN – For the first time in nearly three years, states will resume Medicaid eligibility redeterminations and disenrollments, a move expected to result in up to 15 million people losing Medicaid and Children’s Health Insurance (CHIP) coverage. Healthinsurance.org is providing key information about this policy change, including steps consumers can take to stay insured.
The federal spending bill passed in December notified states they could begin disenrollments that have been paused for three years during the COVID-19 public health emergency. As a result of this change, some states could begin disenrollment for those who are no longer eligible as early as April 1, 2023.
“For nearly three years, the public health emergency has allowed millions of people to continue to receive Medicaid coverage, even if their circumstances have changed and they no longer meet the eligibility rules,” said Louise Norris, health policy analyst for healthinsurance.org. “Those people identified as ineligible, as well as people who fail to respond to renewal notices, may be disenrolled from Medicaid over the coming months. That would be a huge change for them. Medicaid beneficiaries need to be aware this is happening and be prepared to act if they are at risk of losing coverage or are disenrolled.”
State notifications are critical
States will begin sending notifications to Medicaid enrollees, either informing them that they’re no longer eligible or requesting information to help the state determine their eligibility.
Healthinsurance.org urges Medicaid enrollees to:
- Make sure their contact information with Medicaid is up-to-date so a notification won’t be delayed.
- Watch for notices to arrive by mail, email, or text messages, and respond promptly to any requests for information. Be aware that the process will vary from one state to another.
- Talk to their employer if they’ve previously waived group coverage to ensure they know how to enroll when the time comes.
“Everyone with Medicaid will have their eligibility re-checked during the 12-month period that starts in April, and although most enrollees will remain eligible for Medicaid, millions will not. We strongly urge Medicaid enrollees to understand as soon as possible whether they qualify for Medicaid going forward,” Norris said. “And if they’re at risk of disenrollment, research about replacement coverage should start as soon as possible, and certainly as soon as they receive notice that their eligibility is being redetermined.”
Don’t miss deadlines for replacement coverage
People who no longer qualify for Medicaid may be eligible for an employer-sponsored plan, a marketplace plan, or Medicare. Depending on the plan, there are different deadlines to enroll.
ACA marketplaces and employers will have special enrollment windows for many of these disenrolled individuals. An employer enrollment period may only be 30 days long, and ACA special enrollment periods are also limited.
“We are facing one of the biggest shifts in health care since the marketplaces first debuted under the Affordable Care Act,” Norris said. “A big concern is that individuals won’t act in time to secure replacement coverage.”
Healthinsurance.org is a free online source of consumer health resources, including information about individual health insurance, major medical insurance and affordable medical insurance.
Amy Fletcher Faircloth [email protected]