Thousands face Medicaid exodus

Pre-covid rules end coverage

/// State Sen. Clarence Lam, a Maryland Democrat who is a physician at Johns Hopkins, speaks during a news conference about a package of health care legislation on Tuesday, Jan. 31, 2023 in Annapolis, Md. Lam has expressed concern about how well the state will be able get health insurance for up to 80,000 people in Maryland who are now on Medicaid but may not be eligible this spring due to the sunset of a COVID-19 health emergency requirement that prohibited states from booting people off Medicaid. (AP Photo/Brian Witte)

ANNAPOLIS, Md. -- Officials are preparing for Medicaid coverage to end this spring for thousands of Americans who no longer qualify, because the federal government reinstated a requirement that existed before the covid-19 pandemic for states to verify the eligibility of recipients.

Michele Eberle, the executive director of the Maryland Health Benefit Exchange, said that beginning in May, the state can start ending Medicaid coverage for those no longer eligible. Maryland, she added, is in a better position to reach people than many other states to either continue Medicaid coverage or move them into other health plans.

"We are working through all of those numbers right now, but we believe it's around 80,000," Eberle told a panel of lawmakers last month. "There's different little discrepancies of those numbers. The numbers we've come up with is about 80,000 that would roll off, people that we'll have to make sure we've got them covered."

The same goes for Kentuckians who signed up for Medicaid during the covid-19 pandemic and will soon have to shop around to maintain health insurance coverage, Gov. Andy Beshear said Thursday.

The Democratic governor said his administration intends to help people through the transition.

"This is a big job," Beshear said at his weekly news conference. "And it's one we've been planning on for many months and it's one that we will continue to refine our planning."

Medicaid enrollment ballooned during the pandemic, in part because the federal government prohibited states from removing people from the program during the public health emergency once they had enrolled.

The program offers health care coverage to roughly 90 million children and adults -- or 1 out of every 4 Americans.

During the global health crisis, about a quarter-million Kentuckians signed up for pandemic Medicaid, the governor estimated. Medicaid is a joint federal and state health care program for poor and disabled people.

Late last year, Congress told states they could start removing ineligible people in April. Millions of people are expected to lose their coverage, either because they now make too much money to qualify for Medicare or they've moved. Many are expected to be eligible for low-cost insurance plans through the Affordable Care Act's private marketplace or their employer.

With President Joe Biden's administration saying it plans to end the national emergencies for addressing covid-19, changes are coming.

It means pandemic-era enrollees in Medicaid will need to have their eligibility redetermined, Beshear said. And for many, it means health coverage decisions are looming in the coming months.

The governor on Thursday predicted that some affected Kentuckians will continue qualifying for Medicaid. Others will be able to switch to Medicare coverage, while others can transition to insurance plans through the Affordable Care Act's private marketplace.

The Department for Medicaid Services and managed care organizations will reach out with more information for people faced with making the transition, the governor's office said.

"We've had the largest number of folks put into Medicaid during this covid [pandemic]," Eberle told Maryland Senate's Finance Committee. "We ran a covid special enrollment period over 2020 and 2021, and our numbers have just skyrocketed in Medicaid, and we don't want to lose those people, so we're working very closely with our department of health."

Maryland will be reaching out to consumers to make sure if they are eligible for Medicaid that their coverage will be renewed. If they are no longer eligible, the state will help get them into qualified health plans, Eberle said. If they age out of Medicaid and are eligible for Medicare, the exchange will help get them on that pathway.

The Maryland Department of Health will be partnering with Maryland Medicaid Managed Care Organizations, the health exchange, the Maryland Department of Human Services and the Chesapeake Regional Information System for our Patients.

"The communications campaign will include paid media, social media messaging, and other advertising and digital campaigns, in addition to targeted outreach by the MCOs," the health department said in an email.

Eberle said Maryland is in a better position than a lot of states, because of its health care exchange. Maryland has an integrated system between Medicaid and qualified health insurance plans, and the state has not stopped doing redeterminations about qualifications, she said, while other states have not done them for three years.

"We've continued to do those redeterminations every single month," Eberle said. "Now what that means is we didn't terminate anyone, but we sent them notices. We said if you have a new email address, a new phone, come back, update us, so we're better off in that we have current information."

Kentuckians also can seek help through the state-run web portal known as kynect, the health insurance exchange where Kentuckians can shop and sign up for health coverage and find out whether they qualify for subsidies to help afford coverage.

"We want to ensure all the Kentuckians impacted -- every single one of them -- are transitioned to one of the new plans," Beshear said. "There's much more information to come, but we want to let people know about these changes very early."

Still, some are concerned by the sheer number of people who could be affected.

State Sen. Clarence Lam, a Howard County Democrat who also is a physician at Johns Hopkins, noted that it's a huge number of people who could suddenly lose health insurance. He said he believes "the jury is out" on how the change will be handled.

"We are very concerned," Lam said in a recent interview. "We made a lot of strides during the pandemic. We don't want the post-pandemic period to be a period where we see the greatest number of Marylanders thrown off our health insurance rolls."

Suzanne Schlattman, a consumer health care advocate in Maryland, said she has been impressed by the level of collaboration between state agencies to address the matter.

Schlattman, who is the deputy director of development and community outreach for Maryland Citizens' Health Initiative, said the biggest challenge will be in reaching people who got enrolled in Medicaid for the first time during the pandemic, which marked a unique period when they did not have to update their information.

Maryland has about 1.7 million people in Medicaid, Schlattman said, the highest number she has seen. In that context, 80,000 doesn't seem so high, especially compared to what some other states are facing, she said.

"Other states are looking at a much larger shift and a much bigger bottleneck in getting people enrolled," Schlattman said.

Beshear commonly refers to health care as a "basic human right." Last year, the governor extended Medicaid coverage for dental, vision and hearing care to hundreds of thousands of Kentucky adults.

His father, Steve Beshear, championed the state's Medicaid expansion when he was governor. More than 400,000 people were added to the Medicaid rolls when Steve Beshear expanded the program to cover able-bodied adults. For many Kentuckians, it was their first time having health coverage.

Information for this article was contributed by Brian Witte and Bruce Schreiner of The Associated Press.