Since the end of pandemic protections for Medicaid enrollees in the spring, the nation’s health insurance system is witnessing a tremendous upheaval, with an estimated 8.2 million people needing to find new coverage.
This has left many patients unsure of how to obtain new medical insurance.
Taffy Morrison, who works with the non-profit Southwest Louisiana Area Health Education Center to connect Louisiana residents to new coverage, described the task as “overwhelming.” Morrison, however, reminds people: “Don’t panic. There is help.”
The majority of those booted off Medicaid, a state-federal health insurance program for people with poor incomes and disabilities, will obtain new coverage through their employers. Others may need to replace their coverage through the Affordable Care Act’s online marketplaces.
Elevance insurance officials informed investors in mid-July that they were observing signs of movement from Medicaid to exchange plans as states intensified their evaluations of who remains eligible for the public insurance program. The company, formerly known as Anthem, reported an increase of 18.2% in its exchange plans from the previous year, with its marketplace plans now encompassing at least 949,000 individuals.
To prevent lapses in coverage, certain states, including California and Rhode Island, will automatically enroll individuals who lose Medicaid into such marketplace plans. In other parts of the country, however, Morrison and employees of similar non-profit health organizations assist individuals in navigating the complex administrative process of selecting the appropriate plan. They are referred to as “navigators” or “assistants” and are publicly funded; they provide patients with complimentary assistance.
Consumers should be wary of anyone who charges to help them locate coverage or promotes a specific plan. Some individuals have chosen non-insurance plans, such as health care sharing ministries, which do not necessarily cover members’ medical expenses, due to deceptive marketing.
With the end of federal Covid pandemic protections, a dramatic reorganization of insurance coverage ensues. To ensure that individuals had access to health care, states were prohibited from removing Medicaid enrollees during the pandemic. As a consequence, between February 2020 and December 2022, the program will cover approximately 92 million individuals, including children covered by CHIP, the Children’s Health Insurance Program. Now, for the first time since 2020, states have resumed verifying the eligibility of enrollees.
Healthcare Crisis: Over 3.7 Million Americans Lose Medicaid Coverage Amidst Stringent State Reviews
The first wave of data has begun to arrive. To date, more than 3.7 million individuals in 39 states and the District of Columbia have lost coverage. According to state data, more than 50,000 of them resided in Louisiana in June alone. In a single month, the state reviewed the files of more than 151,000 Medicaid recipients and determined that nearly 13,000 no longer qualified for the program. Roughly 38,000 additional Medicaid recipients lost coverage because they failed to submit a renewal packet.
As coverage losses are anticipated to increase, Morrison’s group of fifty navigators throughout the state will now attempt to reduce these figures.
Patient advocates in Louisiana and elsewhere concur that Medicaid enrollees must complete and return their renewal packets, regardless of eligibility status.
Geoffrey Oliver, who directs Connecting Kids to Coverage, a program of Legal Services of Eastern Missouri that assists families with the enrollment process, stated, “That Medicaid paperwork, it’s beneficial for everybody to finish it up.”
If individuals return the forms and are determined to be ineligible, states forward their information to healthcare.gov and other online insurance exchanges. The exchanges will follow up with individuals and inform them of their health plan options, serving as an additional prod on the shoulder to prevent individuals from becoming uninsured.
According to insurance experts, people shouldn’t presume they can’t afford marketplace plans. Many are eligible for low-cost or free coverage. According to federal estimates, roughly 2.7 million people will likely be eligible for discounted plans, representing roughly one-third of those who are not expected to qualify for Medicaid. Approximately 1.7 million will be eligible for zero-premium plans.
Children may be eligible for public plans even if adults in the household no longer qualify for Medicaid coverage or have employer coverage.
In large, bold letters, a Randolph County, Missouri, billboard reminds residents to renew their Medicaid: “Don’t miss this letter.” According to a tally maintained by Washington University in St. Louis, approximately 34% of residents in the central Missouri county have Medicaid coverage.
Harvard assistant professor of health policy Adrianna McIntyre stated that if individuals across the nation neglect to submit the renewal packet, they run the risk of slipping through the gaps. Uninsured individuals may delay preventive care in order to avoid incurring crippling medical debt in the event of an emergency.
According to KFF, the majority of the millions of people who have lost their Medicaid benefits so far did so because they failed to complete the necessary documentation, not because they were deemed ineligible. Patient advocates are concerned that enrollees may have never received the packet. Many recipients have likely moved and changed their addresses, but have not updated their state contact information. Advocates are concerned that these problems may be exacerbated in areas such as Louisiana, where many people have been displaced by floods and hurricanes over the past three years.
In certain jurisdictions, Medicaid recipients can verify their eligibility online. They can ask gratis navigators, such as Morrison, to check on their shipments elsewhere.
Guiding Your Way to Insurance Coverage: Key Information to Keep in Mind
The most crucial step is to complete, sign, and return the Medicaid renewal packet.
If you are no longer eligible for Medicaid, you will have a special enrollment period to locate alternative coverage. Typically, you have 60 days before losing Medicaid coverage to enroll in a new plan; enrollment packets should arrive prior to losing coverage, so this should serve as a warning that a change in your benefits may be forthcoming.
You have 60 days to enroll in a new plan from the date you report the loss of coverage, not the date you actually lost coverage. The clock begins when you submit a new application through healthcare.gov, per federal regulations.
Plan ahead to avoid lapses in coverage. The majority of market coverage commences on the first of the following month.
Here are potential coverage options for you and your family:
- Enroll in insurance provided by your employer. Losing Medicaid opens a special enrollment period for you to enroll in your employer’s insurance, if one is offered.
- Enroll in a plan under the Affordable Care Act. If coverage through your employer is unavailable or unaffordable, you and your family may qualify for a discounted plan on the exchange. If your portion of the monthly premium for the lowest-cost family plan exceeds 9.12 percent of your household income, your family members may be eligible for a subsidy-eligible exchange plan.
Workplace insurance may be affordable for the father but not for the rest of the family, for instance. “In that situation, Dad should enroll in the employer-sponsored insurance plan and then they should go to the marketplace for the rest of the family,” said Geoffrey Oliver, a navigator who directs Connecting Kids to Coverage, a program of Legal Services of Eastern Missouri.
Your children may still qualify for Medicaid even if you no longer do.
Even if their parents or guardians no longer qualify for Medicaid, their offspring may still be eligible. In some areas, children can qualify for the Children’s Health Insurance Program (CHIP) with a family income of up to 400% of the federal poverty level, or $120,000 per year.
What to do before turning 19 and losing coverage under CHIP:
Some young adults will no longer be covered by CHIP at age 19. Prior to losing public coverage, it is crucial for them, especially those with chronic health conditions, to enroll in a plan under the Affordable Care Act during the special enrollment period.
If your 19th birthday falls in the middle of the month, such as in September, you should select an exchange plan in August because most marketplace coverage begins on the first of the following month. This guarantees that you will not experience a coverage lapse when your CHIP coverage expires.
Source: NBC News