Posted on Jun 01, 2023

Medicaid risk

Medicaid Recipients Who No Longer Qualify Will Most Likely Transition To Employer Coverage

Those who obtained Medicaid coverage during the COVID-19 public health emergency must now prove they are still eligible for the program, since the public health emergency is over.

An estimated 18 million Medicaid recipients must re-apply or they will risk losing coverage. However, a recent study funded by an insurance industry trade group showed that the majority of those Medicaid recipients will transition to employer-provided coverage.

An AHIP-funded project, carried out by NORC, provided statewide estimates for the number of Americans predicted to lose their Medicaid coverage during redetermination.

The research found that, in nearly all states, the majority of those impacted by the Medicaid redetermination will obtain coverage through an employer.

Variation across the states ranges from the lowest proportion (48.9%) in Georgia, to the highest proportion (57.1%) in Delaware, enrolling in employer-provided coverage.

3.8M current Medicare recipients to be uninsured

However, research found that not everyone will remain in coverage. About 3.8 million (or 21.2%) of people who lose Medicaid coverage during redetermination are estimated to become uninsured. Variation ranges from 17.7% in Massachusetts to 26.2% in South Dakota.

According to the study, about 15% of children who are subject to Medicaid redetermination will transition to CHIP coverage. 7% are estimated to transition to individual coverage, such as Affordable Care Act coverage, while another 3% could be eligible for other public health insurance coverage.

States that received extra Medicaid funding under a 2020 COVID-19 relief bill had to agree to pause beneficiaries’ eligibility verifications. The continuous enrollment in Medicare was set to end when the public health emergency ended on May 11.  Known as The Great Unwinding, the undoing of many health coverage requirements and incentives put into place as a result of the COVID-19 public health emergency declaration and related legislation will be undone when the public health emergency is over.

Majority of people who will lose coverage are likely to qualify for coverage under the Affordable Care Act, according to public-health officials and advocates.

Read the full news article by Susan Rupe here.

We understand how difficult it can be to navigate the MassHealth system, and that's why we want to help. If you or someone you know is at risk of losing their Medicaid benefits, we urge you to reach out to our law firm for assistance. We can help draft the renewal application to ensure that all necessary information is included and that it is submitted on time.