300,000 North Carolinians who were able to access government health insurance starting in 2020 are set to lose it

Nearly 300,000 people in North Carolina are on track to lose their government health insurance by the middle of next year.

The estimate comes from the state Department of Health and Human Services, which is rolling out a plan to check Medicaid recipients’ family, health and income information to make sure they are eligible for the insurance plan.

States must begin checking Medicaid eligibility of enrollees for coverage in April, with the aim of weeding out those who are not eligible over the next 12 months.

Before the COVID-19 pandemic, people who used Medicaid were verified each year with information such as income and family size to see if they continued to meet eligibility. People who use Medicaid can gain and lose coverage due to fluctuations in their income or changes in family circumstances.

Beginning in March 2020, states were prohibited from cutting people from Medicaid to keep people uninsured during a public health crisis.

The federal government pays most of the cost for Medicaid. During the months when the federal government asked states to stop re-certifying Medicaid enrollees, it also gave states additional money to keep people insured.

As he pushed for Medicaid expansion last year, state health officials told a legislative committee that recertification would be an uphill task. State officials said many people who would lose their insurance would be in the pool of people who would qualify under Medicaid expansion.

Last year, the legislature took steps toward expanding Medicaid, which would have made about 600,000 people eligible for insurance. Many are low-income adults without dependent children. The expansion legislation has stalled, but it is possible that it will go ahead this year.

North Carolina has 2.9 million people enrolled in Medicaid this month, compared to 2.7 million in March 2020.

With so many people being verified, many worry that some will accidentally lose their insurance. The task of renewing all enrollees will include finding those who have moved over the last three years.

“There’s a great deal of concern about this,” said Doug See, a senior litigation attorney with the Charlotte Center for Legal Advocacy. “The word needs to get out.” The Advocacy Center is considering hosting a webinar for health care providers “who need to understand what’s happening, what the safety is and where to send people,” Si said. Medicaid enrollees can also turn to NC Medicaid Ombudsman For details, he said.

There are a wide range of people most likely to lose Medicaid coverage: those for whom the Departments of Social Services do not have accurate addresses; parents or carers whose children are no longer under the age of 18; parents and carers whose income has increased; and youth who turned 19 or 20 during the public health emergency, according to information provided by Sea.

The NC DHHS provided Policy Watch with its initial Medicaid unwinding plan late last year, but the timeline is now out of date with the passage of the federal budget. The original intention was for the re-certification to begin when the federal public health emergency ended. But the omnibus bill Congress passed in December included a provision that changed that timeline and added state reporting requirements.

DHHS did not make a Medicaid official available for an interview last week, but sent this statement:

NCDHHS is preparing for an extensive assignment requiring Medicaid beneficiaries for coverage. We recognize that people will lose coverage in the process, but our goal is to ensure that those eligible for Medicaid do not lose coverage and that those who are no longer eligible are easily transferred to affordable health plans. We are working with internal teams and county DSS partners to develop an appropriate plan moving forward and to address needs as they arise. We anticipate submitting federally required planning documents to CMS by February 15, 2023.

Wake County has added 20 temporary staff members to help with the recertification, said Katie Thompson, the county’s Medicaid intake manager for families and children.

“Re-certification is nothing new, it’s just that it hasn’t been done in three years,” she said.

While re-certification was halted, it did not necessarily cause all enrollees to communicate with Medicaid offices to report changes in contact information.

She added that while counties are working to verify Medicaid eligibility, disseminating information about re-certification will be critically important.

“When we are ready to reschedule will be a challenge,” Thompson said. She said it is important to tell enrollees if they have moved to contact their local Medicaid office.

More than 200,000 Wake residents are enrolled in Medicaid. Thompson said there is no way to know how many people may lose coverage in the recertification.

He said the state is working on a plan to reach out to Medicaid enrollees with information about recertification, but nothing is formal yet with the counties.

The final legal settlement between DHHS and Medicaid enrollees will help prevent people from losing their coverage without notice, said Sea, who represents enrollees. For example, enrollees who may no longer be eligible for Medicaid for the original reason they signed up—having a child under age 18, for example—may be eligible for another reason. All other causes must be investigated before ending insurance coverage.

Under the settlement, the state agreed that Medicaid enrollees should be able to reach social services departments immediately by telephone. Reported on North Carolina health news a settlement In December.

Under the agreement, busy signals are to be avoided by rolling calls over to an available staff member or by being able to leave messages for callers and return those messages immediately. Telephone hold times should be limited, and callers should be able to leave messages after work hours and on weekends.

States must meet federal requirements to report how many enrollees are renewed each month.

Attorneys who have represented Medicaid enrollees will receive their monthly report on renewals.

“As it progresses, we will have real-time information,” Sagar said.

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