Most adults are unaware of Medicaid re-eligibility.

Back in December, about six in 10 adults enrolled in Medicaid said they were unaware of upcoming redefinitions of Medicaid that could potentially jeopardize their eligibility, according to a new survey by the Urban Institute and the Robert Wood Johnson Foundation.

In particular, 64.3% of adults enrolled in Medicaid or with registered spouses, partners or children have not heard anything at all about the upcoming change, which marks a return to regular Medicaid renewal processes — a figure that has not changed significantly since June 2022.

An estimated 5.1% heard a lot, 13.9% heard a little, and 16% heard very little.

This low awareness was the same across the country, regardless of region, state Medicaid expansion status, or type of marketplace operating in the state. Although fewer adults in the West were unaware of the upcoming changes than in the Northeast (61.3 vs. 66.5%), ignorance of these changes exceeded 60% in all four regions of the country. (The other two were the Midwest and the South.)

Awareness was similar across groups of states depending on whether states adopted the Medicaid expansion of the Affordable Care Act or not (64.5% in states with expansion and 63.7% in states without expansion) or whether states used marketplaces at the states or at the federal level (64.3 and 64.2% respectively).

WHAT IMPACT

On April 1, states can begin excluding Medicaid beneficiaries for the first time since March 2020 under the provisions of the Consolidated Appropriations Act, which removes the pandemic-related ongoing Medicaid coverage requirement and allows states to resume regular renewal processes.

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

The authors suggested that government action could help mitigate the loss of coverage. In addition to providing assurance that the requirement for continuous coverage will be lifted and separated from the public health emergency, the omnibus legislation also requires data to be provided to ensure states comply with federal regulations and offers additional guidance to states to promote continuity of coverage.

Minimizing the rise in uninsured during the rollout will also likely require the involvement of community organizations and navigators to help people complete renewal processes or obtain other affordable coverage such as the Children’s Health Insurance Program, subsidized market plans, or employer coverage.

The Centers for Medicare and Medicaid Services, apparently aware of the issue, are opening a special enrollment period with the ACA for beneficiaries who lose Medicaid or CHIP coverage due to the end of the continuing enrollment requirement. At the end of January, the agency released information about a temporary special registration period under exceptional circumstances from March 31 to July 31.

Marketplaces using the federal platform will give eligible consumers additional flexibility to enroll in coverage during and immediately after the end of the Medicaid Continuous Enrollment Waiver Period, CMS said. It starts on April 1st when the states start redefining.

BIG TREND

Up to 18 million people are projected to lose Medicaid coverage as the continuing enrollment requirement due to the public health emergency ends. The Families First Coronavirus Response Act does not allow state Medicaid agencies to exclude people from enrollment during PHE.

The cumulative spending package passed at the end of 2022 gave states information about Medicaid coverage. Under the bill, states will be able to start processing Medicaid re-determinations starting April 1, whether PHE is in effect or not.

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