Most adults unaware of Medicaid eligibility redeterminations

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As recently as December, about six in 10 Medicaid-enrolled adults said they're not aware of impending Medicaid redeterminations that could potentially put their eligibility in jeopardy, finds a new poll from the Urban Institute and Robert Wood Johnson Foundation.

Specifically, 64.3% of adults enrolled in Medicaid or with an enrolled spouse, partner or child had heard nothing at all about the upcoming change, which marks a return to the regular Medicaid renewal processes – a rate that has not changed significantly since June 2022.

An estimated 5.1% had heard a lot, 13.9% had heard some, and 16% had heard only a little.

This low awareness was consistent across the country, regardless of region, state Medicaid-expansion status or type of Marketplace operating in a state. Although fewer adults in the West were unaware of the upcoming change than ones in the Northeast (61.3 vs. 66.5%), the lack of awareness of the change was above 60% in all four regions of the country. The Midwest and the South are the other two.

Awareness was similar in state groups based on whether states had or had not adopted the Affordable Care Act's Medicaid expansion (with 64.5% in expansion states and 63.7% in non-expansion states unaware) or whether states used state-based or federally facilitated marketplaces (64.3 and 64.2%, respectively).

WHAT'S THE IMPACT?

Starting April 1, states can disenroll Medicaid enrollees for the first time since March 2020 under provisions of the Consolidated Appropriations Act that unwind the pandemic-related Medicaid continuous-coverage requirement and allow states to resume regular renewal processes.

However, enrollees who are unaware of the change may be less prepared to complete the necessary steps to maintain coverage, or, if they are no longer eligible, to obtain other coverage, analysts found.

State actions can help mitigate coverage loss, authors suggested. In addition to providing certainty about the end of the continuous-coverage requirement and de-linking it from the public health emergency, the omnibus legislation also requires data reporting to ensure states follow federal rules and offers states additional guidance on promoting coverage continuity.

Minimizing increases in uninsurance during unwinding will also likely require engaging community organizations and navigators to help people complete renewal processes or obtain other coverage that may be available, such as the Children's Health Insurance Program, subsidized marketplace plans or employer coverage.

The Centers for Medicare and Medicaid Services, seemingly aware of the problem, is opening a special ACA enrollment period for beneficiaries losing Medicaid or CHIP coverage due to the end of the continuous enrollment requirement. In late January, the agency released information on a temporary Exceptional Circumstances Special Enrollment Period, from March 31 through July 31.

Marketplaces using the federal platform will be providing additional flexibility for eligible consumers to enroll in coverage during and immediately following the end of the Medicaid continuous enrollment condition unwinding period, CMS said. This starts on April 1 as states begin redeterminations.

THE LARGER TREND

Up to 18 million people are projected to lose Medicaid coverage as the continuous enrollment requirement put in place under the public health emergency ends. The Families First Coronavirus Response Act prevented state Medicaid agencies from disenrolling people during the PHE.

The omnibus spending package that passed at the end of 2022 gave states a heads up on Medicaid coverage. Under the bill, states will be able to begin processing Medicaid redeterminations on April 1, whether the PHE is in place or not.

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com