A new analysis shows 62% of adults enrolled in Medicaid are unaware of upcoming eligibility redeterminations that will happen after the COVID-19 public health emergency ends.
Redeterminations could take place as soon as the spring and could affect millions of people, according to the Robert Wood Johnson Foundation, which funded the Urban Institute study.1 Affected beneficiaries may no longer be eligible, or they may need to update their personal information, verify their income or take other action to remain enrolled.2
The survey found that among those who were aware of eligibility redeterminations:
- 16.2% had received some information
- 15.7% had received only a little information
- 5% reported receiving a lot of information.
The most common sources of this information were:1
- Media, including social media, television, radio and newspapers (34.3%)
- A state agency (30.6%)
- A health insurance company or plan (24.5%)
- A doctor’s office, clinic, hospital or other health care provider (17.8%)
- Somewhere else (6.5%).
Among people who received information from health plans or state agencies, the information was typically a notification of the need to renew coverage (50.4%). Also received were requests to update contact information (36.4%), requests to verify or update income or other factors that could affect eligibility (34.4%), information about other coverage sources (29.1%) or information on obtaining consumer assistance during the renewal process (21.3%).1
In 2020, the Families First Coronavirus Response Act prohibited states from disenrolling Medicaid beneficiaries during the PHE in exchange for increased federal funding.1 HHS will provide 60 days’ notice before terminating the PHE, which otherwise is renewed for 90-day periods. The Biden administration recently indicated the PHE would extend beyond January, which would make spring the earliest likely end date.1 Once the PHE ends, states have 12 months to begin redeterminations and must complete them within 14 months.
KFF has estimated that up to 14 million people will lose Medicaid coverage during this process, and people who have moved during the pandemic, people with limited English proficiency and people with disabilities may have a higher risk of losing coverage.3
If these beneficiaries are unable to transition to other coverage, a large increase in the number of people without insurance could put a strain on many facets of the US healthcare system. This poses a significant risk, as a recent MACPAC analysis on coverage transitions for people disenrolled from Medicaid or separate Children’s Health Insurance Plan coverage found very few transitioned to federal Marketplace coverage.3 This indicates there are barriers in moving from Medicaid to other coverage, and easing these transitions could help reduce the amount of people left without insurance after the redeterminations, KFF notes.
Study authors point to an opportunity for state agencies to improve their communications, given that media or social media was the most common source of information for beneficiaries who had heard about redeterminations. In particular, more information about consumer assistance could help minimize the amount of people who become uninsured. About 20% of those who had received information from a state agency or health plan also got information about consumer assistance, but this information “may need to become more widely available given the importance of assistance in helping enrollees navigate renewal.” Additionally, less than one-third of survey respondents had received information on other coverage options, underscoring the need to connect beneficiaries to new sources of coverage.
The authors note that communication has been challenged by the fact that there is still no specific end date for the PHE. However, Medicaid agencies that work now to prepare beneficiaries for redeterminations will help mitigate the impact on the overall healthcare system and will see a smoother process and healthier population.
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References
- Haley, J., Karpman, M., Kenney, G., Zuckerman, S. Most Adults in Medicaid-Enrolled Families Are Unaware of Medicaid Renewals Resuming in the Future. Robert Wood Johnson Foundation. Urban Institute. November 2022. https://www.rwjf.org/content/dam/farm/communication_and_promotion/promotion_or_communication/2022/rwjf470767
- Haley, J., Karpman, M., Kenney, G., Zuckerman, S. Most adults in Medicaid-enrolled families are unaware of Medicaid renewals resuming in the future. Urban Institute. Nov. 15, 2022. https://www.rwjf.org/en/library/research/2022/11/most-adults-in-medicaid-enrolled-families-are-unaware-of-medicaid-renewals-resuming-in-the-future.html
- Tolbert, J., Ammula, M. 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Requirement. KFF. Nov. 16, 2022. https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-the-unwinding-of-the-medicaid-continuous-enrollment-requirement/
