By Tami Luhby, CNN
The Biden administration wants to make sure states are doing everything they can to minimize the number of Medicaid enrollees who end up without insurance once states recover the ability to screen out ineligible recipients next month.
The Department of Health and Human Services sent governors a letter this week advising them to take steps to reduce coverage losses, which could affect millions of people.
“I urge you to ensure that your state implements all possible options to prevent eligible individuals from losing coverage,” HHS Secretary Xavier Becerra wrote in bold in the letter, shared exclusively with CNN.
States risk losing the increased federal Medicaid funding for the rest of this year if they fail to meet various requirements in their eligibility reviews, Becerra wrote. They should try to ensure they have up-to-date contact information for members and communicate with recipients through multiple methods before canceling coverage based on returned mail. Additionally, states must report monthly renewals and cancellations, among other metrics.
Keep people enrolled
States have not been able to drop Medicaid coverage for residents since the start of the pandemic in exchange for receiving additional federal funds. This continued coverage requirement, which Congress passed as part of a Covid-19 relief package in March 2020, has led to enrollment in Medicaid and the Children’s Health Insurance Program skyrocketing to more than 91 million people.
That all changes on April 1, when states can once again start disenrolling Medicaid recipients thanks to the federal spending package Congress approved in December. Enhanced federal matching will be phased out throughout the year, taking some of the pressure off states to quickly reduce their Medicaid rollups.
States have until the end of May 2024 to re-determine enrollee eligibility.
A total of about 15 million people could stop receiving Medicaid when the continuous coverage requirement ends, according to an HHS analysis published in August. About 8.2 million people would no longer qualify, but 6.8 million people would be laid off even though they are still eligible. That can happen for procedural reasons, including failure to respond to requests and failure to provide necessary information to state agencies.
As much as 6.7 million children are at risk of losing coverage, though the vast majority will still be eligible, according to the Georgetown Center for Children and Families.
Many who are no longer eligible for Medicaid could switch to highly subsidized Affordable Care Act plans or other coverage, such as job-based policies. To ease the transition, HHS created a special enrollment period that allows affected Americans in states that use the federal exchange to enroll in policies through July 31, 2024.
It is not known how many people who dropped out of Medicaid will end up without insurance. Much will depend on how states handle eligibility reviews.
However, state agencies face multiple obstacles in undoing the provision of continued coverage. Many are short-staffed and have to work with outdated technology. Also, they may not have accurate contact information for their affiliates, which has always been a challenge, but could be even more so now as more people may have changed addresses during the pandemic.
The CNN Wire
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