Medicaid Changes: What You Need to Know About Losing Coverage

Medicaid is a government program that provides health insurance to low-income people, and it has just undergone significant changes. Starting April 1, 2023, states began removing people from the program for various reasons, including those who earn too much money to qualify, those who have moved out of state, and those who have gained health care coverage through their employer. 

Before the COVID-19 pandemic, people regularly lost Medicaid coverage for these reasons. During the pandemic, however, the government suspended procedures that would remove people from the program. Now, with the pandemic slowing down, the government has asked states to restart eligibility checks, and 15 million people, or roughly 1 in 6 of the 84 million on Medicaid, are projected to lose coverage.

Many people currently on Medicaid have relocated or received an income boost that makes them ineligible. However, many are likely to be dropped from the program for administrative reasons, such as not receiving a form they need to fill out to re-verify their income and eligibility. 

Those who lose Medicaid coverage may be eligible to get healthcare coverage under the Affordable Care Act's Health Insurance Marketplace. People who lose Medicaid coverage can submit an application at any time during the special enrollment period, which started March 31, 2023, and will last through July 31, 2024. They will have up to 60 days to select their plans. However, coverage through the Health Insurance Marketplace or through an employer is often vastly different from what Medicaid offers.

The timing of disenrollment depends on each state. Some states have already started the disenrollment process, while others are expected to take between nine months and a full year to complete the verification process. Healthcare advocates are urging people on Medicaid to update their contact information, including their home address, phone number, and email, with the state.

If you rely on Medicaid, states will mail a renewal form to your home. The federal government also requires states to contact you in another way – by phone, text message, or email – to remind you to fill out the form. While most states have already used texting for reminders to get a COVID-19 vaccine or attend an upcoming doctor's visit, sending mass texts on Medicaid eligibility will be new.

More than half of U.S. children receive health care coverage through Medicaid or the Children's Health Insurance Program (CHIP). But even if an adult loses Medicaid coverage, it doesn't mean their kids will. Even if you receive a notice that you're no longer eligible for Medicaid, it's likely that your child still qualifies for the program or for health care coverage through CHIP. CHIP covers children whose families make too much money to qualify for Medicaid but don't earn enough to afford private health insurance.

The Consolidated Appropriations Act, signed last December, instructs states to restart eligibility checks of every person currently on Medicaid. To stay in the program, individuals will have to fill out forms to verify their personal information, including their address, income, and household size. The government aims to remove people who are no longer eligible for the program and reduce Medicaid fraud.

The changes to Medicaid have already had a significant impact on millions of Americans, many of whom have been left without health insurance. It’s crucial to update contact information with the state, fill out any necessary forms, and seek alternatives for coverage. There are options such as the Health Insurance Marketplace, employer-sponsored insurance, and websites like MDsave that are available to anyone paying for medical services out-of-pocket and looking to save money. 

Ultimately, it's essential to be aware of the changes to Medicaid and take the necessary steps to ensure you have the ability to cover your healthcare needs.