Coalition aims to keep people covered as Medicaid unwinding begins

Image of the word "Medicaid" under a hole ripped in a dollar bill

By Susan Rupe

As the COVID-19 crisis ends, states are beginning the process of redetermining whether those who are on Medicaid are still eligible for the program as they address the impacta of the Medicaid unwinding.

States that received extra Medicaid funding under a 2020 COVID-19 relief bill had to agree to pause beneficiaries’ eligibility verifications. The continuous enrollment in Medicare was set to end when the public health emergency is over, which is likely to happen sometime in 2023. Known as The Great Unwinding, the undoing of many health coverage requirements and incentives put into place as a result of the COVID-19 public health emergency declaration and related legislation will be undone when the public health emergency is over.

Under the $1.65 trillion federal spending bill approved by Congress in December, states can begin disenrolling people from Medicaid in April even if the public health emergency designation remains in place. Many of those who will lose coverage are likely to qualify for coverage under the Affordable Care Act, according to public-health officials and advocates.

18 million Americans at risk in Medicaid unwinding

An estimated 18 million people could lose Medicaid coverage as part of the Medicaid unwinding.

A coalition of organizations representing millions of American patients, people with disabilities, care providers, employer-related groups, and health insurance providers have come together to launch the Connecting to Coverage Coalition.

As states return to their normal Medicaid operations, the CCC is coordinating with community leaders to ensure that people have access to trusted, reliable information that helps them enroll in health insurance coverage to protect their health and financial security.

The CCC is led by America’s Health Insurance Plans. Jeanette Thornton, AHIP executive vice president of policy and strategy, told InsuranceNewsNet the coalition members have one common goal: to keep people enrolled in some kind of health coverage.

“Our challenge is, how do we make sure that people who are currently enrolled in coverage, maintain coverage – whether it’s in Medicaid or some other kind of coverage,” she said.

Coalition to focus on state activity

“The purpose of the coalition is to share information and research about what is going on in each of the states,” she said. “This really started because we had been seeing a lot of different organizations put up various research reports and other things. But we didn't see where all the different stakeholders were really working together. So that was the genesis of the coalition and why we think it will be a good resource for people as we get to this process underway.”

Thornton said AHIP data indicates about half of those who are found to be ineligible for Medicaid as part of the Medicaid unwinding will be eligible to transition to employer-based coverage, as they have found jobs or gone back to work since the pandemic-related shutdowns ended. Many Medicaid recipients may be eligible to obtain coverage through the Affordable Care Act marketplaces, she added.

She said the coalition’s work will be done in two phases.

The first phase, she said, “is about education and awareness.”

“We must make sure that people who are currently enrolled in Medicaid, understand what's coming and are prepared - whether that’s updating their information, making sure that they know to open their mail when that notice arrives, all of those things. Right now, the coalition has really focused on how to get the word out and get information out.”

Assisting with health coverage transition

The second phase is assisting with the transition to other coverage, Thornton said.

“It’s about connecting people with agents and brokers, connecting people with different enrollment assisters and sharing information,” she said.

The coalition’s website provides Medicaid enrollees, health care navigators, health care leaders, community leaders and other stakeholders with information about the Medicaid redetermination process. Resources include:

Studies and surveys of how people understand and perceive the Medicaid redetermination process.
Frequently asked questions for Medicaid enrollees and their families.
Links to information and guidance from the Centers for Medicare & Medicaid Services, as well as other federal agencies, on the Medicaid redetermination process.
Best practices, key messages, and toolkits for engaging enrollees about what they need to do to determine their eligibility for Medicaid or an alternate form of coverage.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.