As a potential consequence, the Journal reports Medicaid’s enforcement rules might require tweaking, as congressional Democrats and the Biden White House work to “steer eligible people” to other types of coverage.
States that previously received extra Medicaid funding under a 2020 COVID-19 relief bill reportedly had to agree to pause beneficiaries’ eligibility verifications.
And the “continuous enrollment” portion of the state-federal program for the low income and disabled would expire once the federal government’s COVID health emergency has been declared over, which could occur sometime in 2023, the Journal reports.
Under the terms of the omnibus spending bill, states can begin “disenrolling” people from Medicaid as early as April, even if the designation remains in place.
According to public health officials, the people incurring a loss of Medicaid are still likely to qualify for coverage under the Affordable Care Act.
The Journal reports a faction of lawmakers who supported the $1.7 trillion legislation would prefer to remove people who aren’t eligible for Medicaid, if they “earn too much to qualify for the program.”
Within that rationale, as many as 18 million Americans could lose coverage, according to estimates from the Urban Institute, a nonpartisan policy research group.
As of last July, enrollment in Medicaid and its related children’s program had grown by nearly 19 million people, compared with February 2020, according to the Kaiser Family Foundation, a nonprofit group.
On Dec. 12, the Department of Health and Human Services (HHS) issued a proposal that would let state ACA marketplaces launch a special sign-up window for people who lose Medicaid, guarding against potential gaps in coverage.
The potential losses include: People with incorrect personal information on file.
There are also worries that previous Medicaid customers will wind up uninsured because they weren’t aware of the eligibility changes, such as “employer-sponsored health insurance or ACA plans,” the Journal reported.
Next year, Oregon will launch a program to continuously cover children until age 6.
Taking a cue from Oregon, California, New Mexico, and Washington state have requested similarly structured authorizations from the Biden administration.
Children could potentially become eligible for continuous coverage for a year without disenrollment, even if the families’ financial circumstances undergo significant change, the Journal reports.
The Biden administration plans to provide 60 days’ notice before the COVID health emergency ends. The current designation runs through Jan. 11.
As part of the omnibus bill, Medicaid 2023 funding will gradually phase down from April through next December.
To garner enhanced funding, states must agree to certain requirements aimed at preventing erroneous disenrollments — such as updating beneficiaries’ contact information and/or using other ways to contact people.
The states’ “disenrollment” reports will be made public, the Journal reports.
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