States across the U.S. are removing hundreds of thousands of Medicaid beneficiaries from the rolls after the expiration of the federal health emergency that ended in April.
At a meeting of the Indiana Family and Social Services Administration’s Medicaid Advisory Committee last week, members were told nearly 53,000 Hoosiers lost their Medicaid benefits this month after the federal removal of COVID-related coverage protections.
It’s the first wave of an anticipated 300,000 to 400,000 Hoosier beneficiaries who might be dropped from the program after receiving continuous Medicaid coverage for more than three years – coverage that enabled them to see doctors and receive treatment for injuries and illnesses before they became more serious emergency conditions.
During the COVID-19 pandemic, the federal government incentivized states with more matching funds to keep their residents enrolled in Medicaid. Health policy nonprofit KFF ranked Indiana among the top seven states for its policies that encouraged continuous coverage among enrollees.
Hoosier beneficiaries didn’t have to provide any information to retain coverage, even if their income changed, FSSA spokeswoman Michele Holtkamp told The Journal Gazette.
Pre-virus, 1.4 million Hoosiers were enrolled in Medicaid. Last month, there were 2.2 million enrollees, according to the Family and Social Services Administration. Despite efforts to notify beneficiaries of the necessity to re-enroll post-COVID emergency status, 52,985 lost coverage in April, and another 39,611 Hoosiers up for renewal submitted incomplete applications and have been neither re-enrolled nor dropped from Medicaid.
FSSA said it began distributing re-enrollment reminders to Medicaid recipients in December, advising them to update their contact information to ease the determination process. The agency told the Medicaid Advisory Committee it sent 39,052 text messages, made 15,176 outbound phone calls and generated 16,624 emails to enrollees, reminding them to update their information.
“We know that despite our best efforts, members could still be unaware of their need to take action, and not realize they have lost coverage until they need health care,” Holtkamp said. “A 90-day grace period allows them to complete their paperwork without having to restart the application process.”
Fort Wayne’s Neighborhood Health hasn’t yet seen the impact of lost coverage among Allen County’s 132,197 Medicaid enrollees, Director of Mission Advancement Sarah Nease told The Journal Gazette. It, too, provided re-enrollment information to those it serves.
“Our team, including enrollment, has been diligent in providing information and signage for those that may be at risk, so we are hopeful that our patients will not lose coverage or have the necessary resources to find an alternative means of coverage,” she said.
A new national “Medicaid Matters” report suggests actions for states to take to better serve their Medicaid recipients and keep those who qualify from falling through the cracks.
Three organizations – the Center for Popular Democracy, Make the Road New York and People’s Action Institute – surveyed nearly 3,000 Medicaid recipients between September 2022 and February 2023 about their experience in Medicaid. Around half of Hoosiers surveyed – 48% – said applying for coverage was challenging, while about 43% reported difficulties attempting to renew their coverage.
To help solve communications issues between Medicaid administration agencies and beneficiaries, the report recommends state governments dedicate more funding to outreach programs; designate an “unwinding czar” to coordinate with community outreach programs, such as Neighborhood Health; and hire sufficient staff to answer enrollees’ questions.
“We had a simpler program during the pandemic, and it was a better program,” Tracey Hutchings-Goetz, communications and policy director for Hoosier Action, an independent community organization based in New Albany, told The Journal Gazette. “It kept more people covered, there wasn’t a constant churn, and it was cheaper to run, so we know we can do it.”
Dropping 53,000 Hoosiers from Medicaid coverage in just one month, mostly for procedural reasons, demonstrates the need for reform. Other states saw smaller numbers leave the rolls over the previous month, and benefit recipients reported fewer problems applying for or renewing coverage.
FSSA must take swift action to reduce procedural problems, otherwise the projected 300,000 to 400,000 Hoosiers at risk of losing Medicaid coverage over the next 12 months could become our state’s grim new reality.
