Approximately 84 million people are covered by the government-sponsored program. Of this total, about 20 million were added in 2020 during the Covid-19 pandemic.
Typically, to qualify for Medicaid, an individual must prove that their income is below a certain amount set by the government. This amount varies from state to state, but on average, an individual earning more than $30,000 a year does not qualify for the program.
The income of each beneficiary is verified every year. Thus, the government can disqualify individuals from the program who have started earning more than the maximum stipulated amount or have obtained health insurance through their employer, for example.
However, in 2020, due to the pandemic, the federal government approved an emergency law that prohibits states from removing people from Medicaid, even if they are no longer eligible. So, since 2020, the government has not been verifying the income of Medicaid beneficiaries.
But this will change starting this year. With the end of the emergency law approved due to the pandemic, states will be required to resume verifying the eligibility of each person on Medicaid. All members will have to update their registration with information including address, income, employability, family size, etc.
The government estimates that about 14 million people will lose access to this medical coverage due to having income above the amount stipulated by the program.
When will this happen?
This depends on the state you live in; some states are resuming the old criteria faster than others: Arkansas, Florida, Idaho, Iowa, New Hampshire, Ohio, Oklahoma, and West Virginia are among the states that will begin removing ineligible beneficiaries from Medicaid as early as April this year.
Other states will start taking this step in May, June, or July of this year.
Not everyone will be removed from the program at once. States plan to verify the eligibility of all members over a period of nine months to a year.
How will I be notified about the loss of coverage?
The government will send a renewal form to your address. You may also be contacted by phone, email, or text message.
You will have at least 30 days to complete the form. If you do not fill out the form within that period, the states may remove you from Medicaid.
What are my options if I lose Medicaid?
People who no longer qualify for Medicaid can turn to the Affordable Care Act (Obamacare) for new coverage. In this program, they will find medical assistance options that may cost less than $10 per month, depending on income.
However, the coverage offered by Obamacare may be very different from that offered by Medicaid. Typically, these plans have copayments and expenses that must be paid by the member themselves. Additionally, individuals will need to check if the plans offered by Obamacare will be accepted by their doctors.
A special enrollment period will open for people who no longer qualify for Medicaid, starting on March 31 and lasting until July 31, 2024. Individuals who lose Medicaid coverage will have up to 60 days to enroll in a new plan through Obamacare.
My children are enrolled in Medicaid. What will happen to their coverage?
More than half of the children in the United States receive medical assistance coverage through Medicaid or the Children’s Health Insurance Program (CHIP).
Even if you receive a notice that you are no longer eligible for Medicaid, it is likely that your child will still qualify for the program or for health coverage through CHIP, which covers children whose families have income above the Medicaid threshold but do not earn enough to afford private health insurance.
Between 80% and 90% of children whose parents will lose Medicaid coverage will still be eligible for these programs, according to estimates from the Georgetown University Health Policy Institute’s Center for Children and Families.
Source: 5 on Your Side