Thousands could lose Medicaid coverageNebraska is resuming annual eligibility reviews as COVID protections endThousands of Nebraskans could lose Medicaid as COVID-era protections end

Some will be dropped because they are making more money at work, found a job with health benefits, had children move out on their own or have gone through other life changes.

But state officials and community health advocates worry that others may be kicked off the program even if they still qualify because state Medicaid workers won't be able to reach them for newly resumed eligibility reviews. They have launched efforts to prevent people from falling through the cracks.

"The biggest thing is we really, really, really want to make sure we're not dropping anybody from coverage who's still eligible," said Kevin Bagley, state Medicaid director.

During the public health emergency, Congress required states to keep everyone on Medicaid who enrolled on or after March 18, 2020. The move was intended to ensure as many people as possible had health coverage during the pandemic.

But, under pressure from Congress, President Joe Biden announced last month that he was ending the COVID emergency as of May 11. That set off a national "unwind" process under which states must start reviewing Medicaid recipients again, as they did pre-pandemic. States will have to contact every person on their Medicaid rolls and verify their eligibility over the next 12 months.

Bagley said Nebraska will start reviews March 1, with some people possibly losing coverage as of April 1. Medicaid recipients with April and May renewal months will be reviewed first. Over the coming year, all 390,642 people on the program will be reviewed.

That's more eligibility checks than state workers have ever had to do in a year. The numbers are up partly because people were kept on the program continuously over the last three years and partly because more than 70,000 low-income adults were added through the voter-approved expansion of Medicaid.

In addition, the state will be undertaking the reviews while struggling with worker shortages. Bagley said Medicaid has been operating with about 15% job vacancies. The program also has seen considerable staff turnover, meaning many workers lack experience with terminating coverage.

"It's just a really, really big undertaking for them," said Amy Behnke, CEO of the Health Center Association of Nebraska, which represents the state's community health centers.

Simply getting word to people that they will have to verify their eligibility is a big undertaking as well. Behnke said those who signed up for Medicaid in the last few years have not been through a review previously. In addition, they may have moved or changed phone numbers, possibly more than once, since they originally enrolled.

Bagley said the state is undertaking a major effort to alert people about the reviews and encourage them to update their contact information with the state.

He said people can check and update their information by logging into their ACCESSNebraska account or calling toll-free 855-632-7633. They also can use the ACCESSNebraska account to check what month they will have to renew their Medicaid enrollment.

Letters went out this month to the newer Medicaid recipients at their last-known addresses. If the letters come back as undeliverable, state officials work with the private contractors that manage most Medicaid coverage to reach people by phone, text or other means.

The state also has teamed up with health care provider groups and advocacy organizations to distribute written information and has gone on social media to spread the word.

Behnke said the community health centers have enrollment specialists available to help people make the needed updates to their contact information and, when review time comes, to help them get through the verification process.

Under federal law, the state will have to try three different ways to reach people before ending coverage for not responding. Even if coverage is ended, Bagley said most people can get back on Medicaid without a gap if they provide the necessary eligibility information within 90 days.

Those who lose Medicaid because they no longer qualify will be referred to the federal marketplace, where they may be able to get a health insurance plan at little to no cost, Bagley said. The community health center enrollment specialists also can help people get signed up for those plans.

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