As data from the Medicaid unwinding begins to be released one data measure that will be important to track is termination of Medicaid coverage for procedural reasons. This reason is alarming because it occurs when someone does not turn in their renewal forms, other necessary documentation or errors in state systems. These paperwork reasons do not mean the individual no longer meets Medicaid eligibility requirements as their eligibility has not been confirmed either way. The concern is qualified patients are losing Medicaid and the ripple effects are enormous to patient care and safety net providers.
New data from Kaiser Family Foundation reveals that nearly 70% of people who have been dropped from Medicaid lost coverage due to procedural reasons. This is just the latest evidence of the harmful impact on peoples’ access to health care caused by the recent changes in Medicaid policy. The Centers for Medicare and Medicaid Services, the agency overseeing this process, also recently released data on the April cohort of states that began renewals. In the spring, the federal government began rolling back the pandemic policy that allowed people to stay on Medicaid without renewing each year. This has required patients to reapply for Medicaid, known as Medicaid “redetermination.”
Community Health Centers are Reaching out to Patients Who May Be Affected
In this time of confusion and potential panic for patients whose care could be interrupted, they will turn to trusted partners in their Community Health Center. Health centers are long-standing leaders in outreach and enrollment efforts. They employ dedicated staff, such as health navigators, Community Health Workers (CHWs), and assisters, who help patients and members of their communities understand and enroll in health insurance coverage options.
In this time of confusion and potential panic for patients whose care could be interrupted, they will turn to trusted partners in their Community Health Center.
Nationally, there are 7,000 outreach workers and enrollment eligibility assisters who are available to guide enrollees through the health insurance process. According to HRSA data, in 2021, health centers provided 3.7 million enrollment assists to the 14.5 million patients they served with Medicaid coverage.
Health centers are confronting this challenge in multiple ways. In recent listening sessions, NACHC has heard from health centers and Primary Care Associations that are working directly in their communities to raise awareness. Following are some examples of what we’re hearing from the field:
- Health centers are training and educating frontline staff on interacting with Medicaid patients and raising awareness on redetermination.
- Health centers are partnering with school health fairs, church events, parent-teacher conferences and many other local events where Medicaid enrollees may engage.
- Community Care Network of Kansas has purchased pizza box ads within local communities. The ads contain a QR code that educates the community on redeterminations.
- The Georgia Primary Care Association (GPCA) has purchased gas station pump ads that explain the Medicaid redeterminations process while individuals fill up their car.
- An Arizona health center is putting flyers up within their internal pharmacies and locally owned pharmacies.
- A health center in Utah brings iPads to events with Medicaid enrollees to show how to access account information (username, password, how to log-in).
- Many health centers and PCAs have been implementing billboard, social media campaigns, TV, and radio ads unique to their communities.
- Many health centers are teaming up with localities and other patient advocacy groups to get the word out.
Additionally, NACHC has had the recent pleasure to meet with health centers in Arkansas, Oklahoma, and Kansas to understand and share the incredible work health centers are doing to keep patients connected to Medicaid. These state spotlights will be shared through NACHC’s blog over the coming weeks.
Health Centers and Primary Care Associations (PCA) should keep an eye out for Medicaid coverage terminations for procedural reasons over the coming months and see how it trends for their state. They should particularly be alert for data showing whether it remains high compared to ex-parte numbers (automatic renewal without forms) and those determined ineligible. If so, then it will be critical to track and communicate with PCAs and state agencies in case additional support is needed to protect health center patients.
View NACHC’s Medicaid Resources
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