Medicaid's pandemic benefits are ending

For nearly 200,000 Ohioans, the end of the federal government's public health emergency for COVID-19 will likely mean the end of their Medicaid benefits.

It's called an unwinding, and it basically means that a requirement for states to keep people continuously enrolled during the pandemic (even if their income changed) will come to an end on March 31. Ohio's Department of Medicaid has already started reviewing its files on the nearly 3.5 million people who currently receive benefits, and renewal packages will start going out next month. Here's what you need to know:

How did expanded coverage work?

In 2020, the federal government decided that cutting someone's health insurance during a global pandemic wasn't a good idea, so it required Medicaid to keep everyone enrolled until officials ended the public health emergency.

They called it "continuous enrollment," and it meant that state Medicaid programs didn't have to process renewal paperwork and forms to verify eligibility.

During the three years this policy was in place, the number of Americans on Medicaid and the Children's Health Insurance Program (CHIP) grew by nearly 28% to 90.9 million participants, according to an analysis by the Kaiser Family Foundation. And the nonpartisan health policy organizations estimated between 5.3 and 14.2 million Americans could lose that coverage during this "unwinding."

In Ohio, the estimate from the actuary for the Joint Medicaid Oversight Committee is that "24.5% of the COVID-driven enrollment gains between 2019 and 2021 will be disenrolled by 2024."

That's about 196,000 individuals.

How will this coverage end?

Ohio's Department of Medicaid won't verify the incomes of its 3.5 million by the end of April or even the end of 2023. The plan (as required by the federal government) is to take a year to unwind this pandemic program. But the first termination notices will be mailed on April 1.

How can I prepare?

The most important thing Medicaid enrollees can do is make sure their contact information is up to date.

If you moved during the pandemic, Medicaid might not have your current address. And eligibility letters as well as requests for additional information will be sent to the address the department has on file. A failure to respond can result in a loss of coverage, according to the department. "As a rule, no individual will be disenrolled without an eligibility redetermination or two failed attempts to obtain verification from the enrollee."

Ohioans can update their contact information by calling 1-844-640-6446, visiting a county Department of Jobs and Family Services, or logging into the Ohio Benefits Self-Service portal.

What happens if I'm no longer eligible?

Anyone can appeal their determination, but Medicaid says there's an important deadline to be aware of when it comes to keeping your coverage during the appeal.

"If they appeal within 15 days of the date of the notice, their healthcare coverage will remain in effect until the appeal process is completed," according to Ohio's department. "If they appeal beyond 15 days, their coverage will be ended, but can be reinstated if their appeal is successful."

For those who don't appeal, Medicaid coverage will end on the last day of the month in which the notice was issued. No termination notices will go out before April 1.

Where do I go for insurance?

Some people who are no longer eligible for Medicaid may have the option of enrolling in their employer's healthcare plan. Everyone else will have to buy coverage on the exchange.

Ohio's Department of Medicaid says it will automatically transfer files to the federal marketplace, and "all notices of termination contain contact information for the federal marketplace navigators who can assist with finding alternative coverage."

Whether the state will do anything else to ease Ohioans through this transition is unclear.

Senate Minority Leader Nickie Antonio, D-Lakewood, said she plans to monitor the unwinding closely. "My core concern always is that people stay consistently in care, and they don't have an interruption."

What is the difference between adult and children's eligibility?

One important caveat to the unwinding is that children can still be eligible even if their parents or caretaker is not.

Adult incomes are limited to 90% of the federal poverty level while children can be eligible if their household earns 206% of federal poverty.

That means an adult earning more than $18,310 a year for a family of two might be ineligible, but their child would be covered until their income exceeded about $36,600.

Anna Staver is a reporter for the USA TODAY Network Ohio Bureau, which serves the Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated news organizations across Ohio.