More than 1 million people have been disenrolled from Medicaid coverage, according to June 12 data from KFF.
Leaders at CMS and HHS urged states to do more to prevent coverage losses after early data showed many people were disenrolled because of red tape and administrative hurdles, rather than because their income no longer qualified for the program.
In seven states, at least 80 percent of those disenrolled from Medicaid were removed because of procedural reasons.
Here is what nine healthcare leaders said recently about coverage losses and strategies for preventing eligible people from being removed from the program.
1. Xavier Becerra, HHS secretary, urged state governors in a June 12 letter to double down efforts to reach beneficiaries who may not know they need to renew their coverage.
"A recent survey of Medicaid enrollees found that two-thirds of people were not sure if their state was returning to regular Medicaid operations. We must all do much more to ensure that everyone with Medicaid or CHIP coverage knows that they must check their mailbox and/or email for a renewal form and return it immediately to maintain their coverage," Mr. Becerra said in his letter. "I urge you to work with local governments, community-based organizations, schools, faith-based organizations and leaders, grocery stores, pharmacies, and anyone else in your communities who can help people understand the Medicaid and CHIP renewal process."
2. Chiquita Brooks-LaSure, CMS administrator, told reporters on a June 12 call the agency is "deeply concerned" about eligible people losing Medicaid coverage during the redeterminations process.
"The reality of our healthcare and insurance system is that healthcare transitions are not seamless," Ms. Brooks-LaSure said. "It takes time and effort to ensure individuals and families make their way back to healthcare coverage that meets their needs. That's why this process is just beginning, and why the initial numbers we are seeing are so important. We need this initial data to employ the right strategies and ask the right questions so we can continue to support individuals, families, states and partners through this process."
3. Daniel Tsai, deputy CMS administrator and director of the Center for Medicaid and CHIP Services, told reporters it is not enough for states to "follow the minimum federal requirements."
"We are monitoring aggressively and making sure that states are following all federal requirements of what Medicaid enrollees are entitled to as they go through the renewal process. If we find any violations, we will use every power that Congress has given to us swiftly and strongly to make sure eligible people maintain coverage," Mr. Tsai said.
4. Kate McEvoy, executive director of the National Association of Medicaid Directors, told Becker's states are focusing on options to restore Medicaid coverage if eligible members are disenrolled during the redeterminations process.
"It is not the end of the story, in the unfortunate event if someone loses coverage," Ms. McEvoy said. "It's not the end of the story, because they can be restored at any point through reconsideration, or come on the program again when they are eligible afresh. That is a unique feature of the Medicaid program compared to private insurance where you might have a yearly annual open enrollment period."
5. Marla Bauer, director of growth and marketing for individual ACA business at BCBS Arizona, advises payers in states where redeterminations have yet to begin to make sure their staff is aware of the process.
"If a member or patient comes in, make sure there's an alert that says they're on Medicaid with any systems or tools you're using so that person knows what things they need to consider. Every touchpoint needs to help people become aware of their current situation — the data and the information are available," Ms. Bauer told Becker's.
6. Diana Kobus, CHIP program director at Highmark Inc., told Becker's that CHIP coverage can be an option for families whose children have lost Medicaid coverage.
"For folks coming off of Medicaid, after the public health emergency, after redeterminations, CHIP is a really great option for a lot of families. Depending on what your income is, you might get CHIP completely free, or you pay a small premium to be covered for all of your primary care needs, preventive care needs, hospital, emergency, telehealth, behavioral health — it's such a robust benefit that is really needed right now as we all come out of this."
7. Mac Davis, vice president of digital product and data at Belong Health, told Becker's he advises plans not to forget about dual eligible members in the redetermination process.
"Medicaid redeterminations have an outsized impact on members in D-SNP plans. Losing Medicaid eligibility will disrupt not only continuity of care with their D-SNP plan providers, but also the important relationship with care managers who help coordinate their care. Because this population is typically more complex and high needs, it's important that we reduce churn as much as possible," Mr. Davis said.
8. Howard Weiss, vice president of public policy and government engagement at EmblemHealth, told Becker's health plans should work with community partners.
"This means working closely with physicians and other clinicians to ensure their patients know how to renew their Medicaid eligibility or find other coverage. For example, EmblemHealth has provided our network physicians with tools they can use to help their patients maintain coverage, including lists of individuals under their care who are scheduled for redeterminations within the next three months and checklists to share with their patients describing the necessary steps to navigate the redetermination process successfully."
9. Don Antonucci, CEO of Providence Health Plan, told Becker's that transparent communication is key, both internally and with all involved organizations.
"We've got to go back to why this is happening and are organizations doing everything possible with community partners to make sure that people understand this process. This is a public campaign and the last thing you want is for anyone to feel in the dark. This isn't just payers, but everyone coming together and making sure the communication is there."