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North Carolina finally expands Medicaid, just in time for massive drop-off in enrollments [1]
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Date: 2023-03-28
As many as 17 million people could lose their Medicaid coverage at the beginning of April. For the past three years, states were barred from dropping people from their Medicaid rolls as a pandemic relief measure. That’s 17 million in the 40 states who have estimated the impact—11 states still haven’t reported data. Before the COVID-19 pandemic, Medicaid enrollees had to reapply for coverage annually under federal rules. Families also had to reapply for the Children’s Health Insurance Program annually.
The COVID-19 public health emergency will expire on May 11, 2023 and states have been given 12 months starting on Apr. 1 to “unwind” the pandemic expansion and return to normal enrollment operations, reverting back to normal eligibility requirements. That means if their income has increased or they’ve had a change in their disability status, they could lose coverage.
Kaiser Family Foundation and the Georgetown University Center for Children and Families asked states about their unwinding process in their annual survey of Medicaid and CHIP program officials in January. Most of the states are taking steps to try to minimize the fall-off by taking the file 12-14 months to work through re-enrollments; using an ex parte or administrative process where the state verifies ongoing eligibility by using existing data sources rather than putting the whole responsibility on the enrollee; taking extra steps to provide outreach to enrollees who could be dropping off; and providing information about the unwinding process on state websites.
It’s mostly the blue states that expanded Medicaid and that have worked to ensure maximum coverage for their populations during the pandemic that are working to keep people insured, whether on Medicaid or in other programs. Some, like Rhode Island, are automatically moving people who lose Medicaid eligibility into an Affordable Care Act plan. That state will pay for the first two months of premiums. Other blue states are enhancing the subsidies for marketplace plans.
About 20 million people gained coverage through Medicaid during the pandemic. It helped bring the uninsured rate to an all-time low in 2022. Over the next 12-14 months, that’s going to change. The states with the biggest uninsured populations before the pandemic—Texas and Florida—have refused to expand Medicaid and aren’t likely to go out of their way to make sure that the people who are losing coverage now find another option.
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[1] Url:
https://www.dailykos.com/stories/2023/3/28/2160539/-North-Carolina-finally-expands-Medicaid-just-in-time-for-massive-drop-off-in-enrollments
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