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Public health emergency expiration may leave many without Medicaid coverage

Dwain Currier via Flickr
Creative Commons 2.0 license

The COVID-19 public health emergency allowed people enrolled in Medicaid to stay enrolled. But as the expiration date for that emergency looms many states are planning for big changes in Medicaid––including New Mexico.

That could mean folks will find themselves either ineligible for the service, or stuck waiting in a bureaucratic nightmare made worse by low staffing. KUNM spoke to Liz Hagan, policy director with national advocacy group United States of Care to learn more.

LIZ HAGAN: What we've seen throughout the duration of the pandemic is related to the Families First Coronavirus Act. Because of that passing, states were really encouraged––and all of the states took this option up––to allow people to stay on Medicaid without having to prove their eligibility on a regular basis like they usually would have to. With this extension, people are able to stay on for the duration of the public health emergency. And now we know that the public health emergency, as of now, is slated to end in October of this year, which means that those so-called “continuous coverage provisions,” which is basically a wonky way of saying people that were enrolled in Medicaid can stay enrolled in Medicaid for a continual basis. Those people will now have to do the eligibility process and see if they're still eligible for Medicaid, which means for some people, they will no longer be able to stay enrolled.

KUNM: In New Mexico, 72% of babies are born under Medicaid coverage according to the state's Human Services Department. That's the highest ratio in the nation. I can't help but wonder what power individual states have in this?

HAGAN: So, states and the federal government basically administer the Medicaid programs. And states do have options in terms of who's eligible, what the process for enrollment looks like. And that piece right there means that the state has a lot of ability to sort of make this process easier for people or on the flip side, to make the process more difficult for people. And I'm not insinuating that Medicaid officials are wanting to make the process more difficult for people to stay enrolled. But rather that there's staffing issues, there's paperwork, there's administrative issues that go along with that, especially because we know so many more people are enrolled in Medicaid. And so there's a large number of people that are going to have to go through that quote unquote, "redetermination process" to see if they're still determined eligible.

So there's things that states are able to do on a small basis that can make sure that people enroll. But there's also other things that states can do. Did they expand Medicaid? Did the state take the action needed to ensure that people up to a higher income level are able to enjoy the benefits of having coverage? And states like neighboring Texas have not done that. But New Mexico has done that, which is partially why the number of people in Medicaid in New Mexico is higher proportionally than it is in the other parts of the country. I think that really speaks to how important it is to have this safety net available to people in the state when they need it most.

KUNM: Who is most impacted by this? And what can they do when they find out they're dropped?

HAGAN: Well, the good news is, there's other coverage available for people and there's coverage that comes with financial assistance for people who are coming off of Medicaid. So, it's not to say that when someone is disenrolled from Medicaid, they don't have any other options. People have access to enrolling in coverage through the marketplace. But there's a premium that comes with it. And for some people, that's going to be a lot of sticker shock.

You could envision a scenario in which many people are disenrolling for Medicaid, and are seeing marketplace options available to them, but they are simply too unaffordable. And we know from years of listening to people, every time you talk to someone about their coverage and what they want to see in their coverage, they're concerned about affordability and they're concerned about dependability. They're concerned that what they need when they need it is not going to be there. And the American Rescue Plan Act's financial assistance was what was provided, because that's going away, people are going to be left in a spot where unaffordable coverage is the reality for them.

I think there's a really big opportunity for people throughout the country to voice that. We need to see these continue. People are benefiting, neighbors are benefiting, family members are benefiting. I think a role we can all play in making sure that our elected officials are aware of how important that particular piece is so that when people are losing their Medicaid coverage, they still have something that they can rely on and use when they need it.

A virtual webinar on Wednesday, July 27th hosted by United States of Care aims to inform those enrolled on what options are available and what the impacts of the expiration will be. The hour-long webinar will include experts answering questions from registered participants.

Visit the New Mexico Medicaid portal.

Bryce Dix is our local host for NPR's Morning Edition.
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