Millions on Medicaid in Jeopardy as Pandemic Protections Expire

• If you are being dropped from Medicaid, you do have options for health coverage. If you are working, you can see if your employer offers a health plan you can afford. You can also see if you can get coverage through the Affordable Care Act (ACA). Losing Medicaid coverage qualifies as a “qualifying life event” so you won’t have to wait for the annual marketplace open enrollment period to get an ACA plan. You’ll also be able to apply for a subsidy to help you afford any monthly premium. According to one analysis, nearly one-third of people who are likely to be removed from the Medicaid rolls will be eligible for an ACA subsidy to help them afford health insurance.

• Even if you get a letter saying you no longer qualify for Medicaid, you can still reapply, especially if your financial or medical situation has changed. There is no limit on how many times you can apply.

• If you were on Medicaid when you turned 65 and you didn’t sign up for Medicare, you can apply now and not be subject to any late-enrollment penalty. You’ll have a special enrollment period that will start the day your state tells you that your Medicaid coverage is ending and will last for six months. You’ll have to apply for Medicare through the Social Security Administration.

• If you are what is called a dual eligible — meaning you have Medicare and Medicaid — nothing will change unless you are told that you no longer qualify for Medicaid. If that’s the case, your Medicare coverage will continue unchanged.

“Now is the time to make sure your state Medicaid program has your updated contact information,” says Jordan Endicott, an AARP government affairs director. “People could lose coverage just from not responding to a state’s letter.”

Over 2.5 million older adults could lose eligibility

AARP’s state offices have been contacting state Medicaid officials to urge them to do all they can to make what is being called the Medicaid “unwinding” process as consumer-friendly as possible. 

In a letter to state officials, AARP calls this effort to determine the eligibility of millions of Medicaid recipients “a monumental administrative task, but the stakes are also incredibly high for the individuals that have come to rely on Medicaid health coverage during the COVID-19 pandemic.”

Between February 2020 and December 2021, Medicaid enrollment grew by more than 20 percent to nearly 87 million recipients from just over 71 million, according to federal government data. In a report issued last summer by the Department of Health and Human Services, officials estimated that more than 2.5 million older adults — 967,000 Medicaid recipients ages 45 to 54, 777,000 ages 55 to 64, and 791,000 age 65 and older — would no longer be eligible for Medicaid when the recertification process is done nationwide.

AARP is urging states to: increase the Medicaid workforce to handle this redetermination effort; streamline the verification process; give beneficiaries enough time to send the state the required renewal documents; make sure people know they need to update their contact information; and work with community organizations to help get the word out about this process.

“Going through this next year will be quite a challenge,” Endicott says, especially for people who signed up for Medicaid during the pandemic and have never been through a recertification process.