Last night, we reported on the expansion of Medicaid and North Carolina,
one of them a number of states once opposed to doing so Medicaid
has grown substantially over time. More than 90 Million people now
are on it. But the end of the pandemic is also leading to another
big change with Medicaid as many as 14 million people could lose
Medicaid coverage in the months ahead. William Branham has the details.
I'm not before the pandemic, people had to re enroll every year for
Medicaid by submitting paperwork to prove that they were eligible
that was suspended during the height of the pandemic, and afterwards,
But starting this month, Medicaid recipients have to make sure they
are enrolled again. The problem while there are many among them,
not everyone will receive a notice or complete the applications on
time. Many will fall through the cracks to the changing addresses
or language barriers. We'll hear about these problems and the efforts
to re enroll people in a moment. But first, let's begin by hearing
some of the folks on the ground trying to help recipients get the
coverage they need. The thing is, there's not enough advocates to
assist every person who's going to be un enrolled, um, from Medicaid
in our state. So what we're trying to do collectively in a coalition?
Is to get as much information out into the community as we can into
that education. Florida is one of now just 10 states that has refused
to expand Medicaid under the Affordable Care act, which means we're
going to end up with a lot more individuals who don't have any health
coverage. Um and those people are going to be reliant on places like
their local community clinics, federally qualified health centers.
Um, and charity care, but that's not health coverage. That's that
that maybe access to care. But it's not coverage and it comes with
costs. Much of the application process is online, and we know there's
digital equity issues in these transient and L E P communities as
well. So there's a lot of hurdles. There's a lot of gaps. There's
a lot of barriers. There is significant room for error in the renewal
process and missing a key committee. Cation from the state. In fact,
a significant portion of Cases will be closed due to those sorts
of procedural errors. And so for those people, they're going to have
to start again at the beginning, So we're trying to be as proactive
as we can be to educate Multilingual community members on what this
process is what to look out for in the mail. Into contact us if they
need any interpretation assistance. We know medical. That is a huge
issue, And we know it's a signal more significant issue in states
that have not expanded Medicaid. So for fear of accruing debt, there
will likely be people who do stay away from care once they've lost
their health coverage. This is really the time for our legislators.
To recognize that health care is a human right? The people have
truly benefited from having this, uh, this access to Medicaid over
the past three years. So to help us understand more about what's
at stake and what needs to be done. I'm joined by Jennifer Tolbert,
She's director of state health reform at the Kaiser Family Foundation,
now known as KFF and associate director for the program on Medicaid
and the Uninsured. Jennifer Tolbert. Very nice to have you here.
Pleasure to be here so the pandemic is waning. This Medicaid, auto
enrollment is waning. But in that gap, a lot of people who were eligible
for that care may now be losing that care. How is this going to happen?
Is it going to be a hard deadline where suddenly millions of people
are out of it? How will this unfold right? Well, states are going
to have up to 12 months to conduct a renewal on everyone who is enrolled
in the in the program. So it's important to note that no one will
be dis enrolled from Medicaid until there has been a full re determination
done to assess their ongoing eligibility or to determine whether
there are no longer eligible. But this process will occur over the
next 12 to 14 months, So it's not like everyone is suddenly going
to get a notice in the mail, saying they've been kicked off Medicaid
tomorrow. So that's the good news. But it will be important for people
to look for notices from the state Medicaid agencies in The mail
in the coming months, and when they get that notice, it will be important
for them to take whatever action they need to take. I mean, anyone
that knows that if you're simply relying on something coming to you
in the mail that can cause snafus, language issues, male doesn't
get delivered on time You shift to a different address. I mean, could
there be circumstances where people think they are still enrolled
and then go to the doctor or hospital or pharmacy and find out? No
yes, In fact, that very often happens and it's something that we're
very concerned about. We estimate that about half of the 14 million
people Are expected to lose coverage will remain eligible. But Lewis
coverage anyway, because of these procedural and administrative barriers.
Yeah, as much as half. Yes. So it's a lot of people and in those
circumstances, I mean, we heard from some of these navigators that
are helping people trying to figure out and keep them on track. Are
those people comin in the world out there? I mean, if you're worried
about this, can you find help? Easily? Yes And no, there's not. Unfortunately,
a single place where people can go to find a list of people in the
community available to help them. But they there are people available.
And so it might take a little bit of legwork. But
Reaching out to their providers when they seek care. Some of that
those navigators will be available at provider offices. Community
health centers are a great place for people on Medicaid to go if
they need assistance. I know that you study how states operate these
programs. Are there certain states that are Better prepared for this
Do a better job of this kind of navigation.
Well, we do know is that this is going to play out differently across
states, and that's partly because of different policy decisions that
states are making as well as issues like staff capacity and the capacity
of systems to process. All of the renewal's that states will have
to do. So we are in anticipating that this will you know that that
things will go differently across states. Now The good news is they
have had months to prepare, and they have gotten a lot of guidance
from the federal government on how to do this well of that, estimated
14 million or so people who might lose their eligibility. Or are
there certain groups in particular that might be those falling off
the rolls? Yeah, I think there are certain groups who are at greater
risk. Certainly people with limited English proficiency who are maybe
less likely to get a notice in the mail in the language in which
they speak people who've moved during the pandemic and maybe didn't
or update their information with the state. It will be harder for
the state to reach those individuals. Also, people with disabilities
may just face greater challenges, they often have greater documentation
requirements. To maintain eligibility and that can be challenging
to find those documents and send them back within the required timeframe.
So you mentioned reach out to your provider. Try to find some help
there. If someone is worried about this, what should people do? People
can if they are concerned, they can reach out to their Medicaid agency
proactively to find out when to expect that notice from the state.
They can also just simply be on the lookout for information from
the state. That notice will likely come in the mail and you know,
but there were also other ways. At the state may communicate via
email or text message. So I think the greatest advice is just to
be on the lookout for those notices. When the notice comes open it
right away and read it and take the necessary action. Jennifer Talbot
at KFF. Thank you so much. Thank you.