Medicaid Eligibility Status Remains Elusive as Continuous Coverage Ends

As the era of continuous coverage under the coronavirus public health emergency draws to a close, Medicaid beneficiaries remain unsure about the future of their Medicaid eligibility.

“Medicaid programs nationwide have seen their enrollment numbers climb in recent years from 1) the expansion of healthcare qualifications for ACA plans and Medicaid by the current administration, and 2) the suspension of normal income-based Medicaid eligibility during the COVID-19 pandemic,” said Howard Yeh, co-founder and president of insurance at Healthcare.com.

“As the public health emergency has ended, millions are slated to lose their Medicaid coverage due to the reinstatement of the redetermination rule. For those losing Medicaid eligibility, the ACA marketplace can offer low monthly premiums and essential benefits for individuals without other options.”

The researchers used SurveyMonkey Audience to survey a population of 512 Medicaid beneficiaries.

Almost four out of ten respondents were not sure whether they would remain eligible for Medicaid when states begin the renewal processes on April 1, 2023. Additionally, nearly half of all respondents were unsure if their state would return to processing Medicaid renewals. Over half of the respondents had not received communication about their Medicaid status.

Three out of ten participants were very familiar with the fact that they might need to seek out new coverage after states begin Medicaid renewals. Another 46 percent of respondents had heard something about this requirement. However, a quarter of the participants had not heard anything about restarting Medicaid renewals.

If they lose Medicaid coverage, nearly half of the respondents planned to gain Affordable Care Act coverage through the special enrollment period (47 percent) and nearly six out of ten said they would qualify for subsidies on the Affordable Care Act marketplace. Less than a quarter of respondents would turn to short-term health plans and other alternatives if they lost Medicaid coverage.

“Our results found that these times of uncertainty can lead to new approaches to staying covered,” the researchers said.

In particular, beneficiaries might stay in a less desirable job in order to maintain coverage, while others would accept job offers that they did not want to maintain health insurance coverage. Health insurance even exerted influence over relationship decisions, with some participants saying that they would marry or remain in unhappy relationships for health insurance coverage.

Under Medicaid coverage, beneficiaries said they most commonly used their coverage for prescription drugs (43 percent) or preventive care services (36 percent). The least used service was therapy.

Medicaid enrollment and CHIP enrollment grew 28 percent during the coronavirus pandemic, adding 20.2 million beneficiaries to their ranks by October 2022.

Experts have recommended that states implement various strategies to accommodate the start of Medicaid redeterminations, including communicating with stakeholders and working with various partners.

As many as 18 million beneficiaries could lose their Medicaid coverage after the continuous coverage provision ends.