>> During the pandemic,
enrollment in medicaid the
public insurance program for
those with low incomes surged
more than 28% and the uninsured
rate reached an all-time low.
That's largely because congress
temporarily blocked states from
kicking people off medicaid even
if they were no longer eligible.
But that ends starting at the
end of this month.
As many as 15 million of the 84
million current enrollees could
eventually lose coverage.
A correspondent for Kaiser
health news.
What's called continuous
coverage, not kicking people off
or checking their eligibility,
all ends March 31.
Is this all going to happen at
once on April 1?
People are just going to find
out they are not covered?
>> I think it's pretty unlikely
that someone immediately on
April 1 would get a letter
saying you don't qualify and you
are going to lose your benefits.
States have a year to complete
the whole process and part of it
is because the Biden
administration and congress
frankly trying to make sure that
we have enough time.
They have enough time to go
through everyone to make sure
that people aren't kicked off
unnecessarily when they may
still qualify.
The other thing is because we
have unprecedented numbers of
people on medicaid right now,
it's going to take a lot of
time.
So they have about a year.
Every states timeline might be a
little different.
Some are going to move faster
than others.
>> Are some states already
checking?
>> Some states have begun to
notify people that their
benefits could end soon.
They have begun sending letters
to people letting them know that
starting in April, if they get a
renewal notice and they don't
furnish information needed for
the state to confirm they could
still qualify, they are at risk
of losing their benefits.
That will be starting soon, but
it could be months from now
before someone receives that
notification.
>> And in the meantime they'd be
covered.
>> Yes.
>> Are we essentially going back
to where we were before the
pandemic where there is a
medicaid gap?
People who earn too much to
qualify for medicaid but too
little to qualify for the
subsidies under the affordable
care act.
>> Yes, the states where
medicaid was not expanded,
eligibility was not broadened
under the affordable care act,
those states are
disproportionately in the south
and the midwest.
They are going to have very
restrictive eligibility levels
once again.
Especially for adults without
children.
Because of course medicaid
covers so many people that how
you qualify based on your income
varies depending on whether you
are a senior in a nursing home,
whether you are a pregnant
person who is currently
receiving medicaid, whether you
are a child.
I think the risk, people who are
trying to ensure that coverage
is maintained for those who are
eligible, certain people are at
higher risk for losing their
benefits, especially adults
without children and parents and
their children.
Those are people who are
especially vulnerable.
>> Why those groups?
>> Children in particular a lot
of the time their health
insurance status will depend on
their parents.
If the parents aren't in short,
they are not necessarily going
to get their children insured.
Certain groups who are on
medicaid are more likely to
experience instability in their
income, housing and jobs.
Those people don't always stay
consistently on the program.
Those people may be qualified
for medicaid at certain points
in the year, but at other points
they don't.
The state needs to be able to
reach those people to really
ensure that their income is
within the limits that medicaid
prescribes.
>> In a normal year they are
constantly checking to see
people's income levels to make
sure they are still eligible.
This sounds like a huge
administrative task.
Talk about the fear that people
who are qualified are going to
get dropped.
>> It's been a long-standing
problem even before the
pandemic.
It was a long-standing issue to
get a hold of people on
medicaid.
This population, they are low
income, they tend to be more
transient with unstable housing
and jobs.
All of this was compounded
during the pandemic.
If you are trying to confirm
that someone still qualifies,
you have to be able to reach
them.
You are not necessarily going to
be able to especially when
people have had so much
instability in their lives.
A lot of medicaid verification
work is still done through
paperwork.
It's hard paper, letters that
are sent through the mail.
It's not the most tech savvy
area in terms of trying to get a
hold of people.
It's very common that mail won't
be sent back to the state or it
gets sent to the wrong address
to begin with and I think that
is the risk in all of this
because as we know, this is the
largest medicaid renewal effort
in the program's history.
It's never been this big.
>> Politically it's very tough
to take away something people
are getting from the government.
Is this going to renew the
debate or the push to expand
medicaid nationwide even in the
11 states that didn't do it
under the affordable care act?
>> I think it will depend on the
extent to which people lose
their benefits.
I think it's safe to say there
are people who are receiving
coverage right now who should
not still be on that program
because of their income or
because they have moved out of
state for example.
But that being said, if you
start seeing tremendous numbers
of people losing their benefits,
especially when they might still
qualify, I think you could see a
push again or that used as a
reason to expand eligibility
levels more broadly in the
states that tend to be more
restrictive.