Tens of thousands of low-income Utahns have lost their health insurance in recent weeks and more are expected to lose coverage in the coming months as a pandemic-era federal policy that has prevented states from removing people from Medicaid continues to relax.
More than 15 percent of Utah residents were enrolled in Medicaid when Beehive State’s membership rose to an all-time high of 536,301 in April, according to data from the Utah Department of Health and Human Services. At the end of May, the top 39,000 people, more than one in 100 Utah residents, had their health care coverage terminated.
Medicaid enrollees include some of the state’s most vulnerable residents, including the disabled, pregnant women, children, homeless people, and others on low incomes.
Initial data released on the DHHS website indicates that most people who lost coverage were deported procedurally because the state failed to locate them or did not return their paperwork in time.
These numbers have raised concerns among advocates that many of the people who lose coverage are still eligible. And the problem isn’t unique to Utah, large numbers of people in states across the country have started losing their health insurance for the same reason.
Utah expanded Medicaid in 2019, and now the maximum eligible income ranges from $19,392 a year for an individual to $67,278 a year for a family of eight.
According to a dashboard from DHHS, of cases reviewed last month, just over 40% of members had their Medicaid coverage renewed, about 5% were ineligible to keep their plans, 5% of cases were still pending and nearly 48% lost coverage on procedural grounds the state wasn’t sure whether or not they were still eligible because they weren’t able to contact the recipient.
Of those who lost coverage for procedural reasons, several thousand have re-enrolled, DHHS eligibility policy director Jeff Nelson told the Utah Legislature’s Interim Committee on Health and Human Services Wednesday.
In a report form sent to the Centers for Medicare & Medicaid Services, the state said it took multiple steps trying to reach Utahns on Medicaid to make sure they renewed their coverage if they needed to.
The state sent out a flyer in December 2021 and added messages to the Medicaid website and Case Access Portal reminding members to update their contact information. He also reportedly made social media posts, verified addresses via Equifax, and emailed members in September 2022.
Using the addresses it had on hand, Utah began mailing renewal notices this spring. Sending physical-only alerts by mail likely contributed to the low response rate, said Matt Slonaker, executive director of the Utah Health Policy Project.
I think the medium is not suitable, which is mail, Slonaker told the Salt Lake Tribune. How many of us wait until the end of the week to look at our mail and half of it doesn’t even want to open it?
People who rent and those without stable housing may change addresses frequently, and those who are homeless may not have a physical address where they can receive notice, he added. Slonaker suggested text messaging might have been a better method of reaching people.
Unfortunately, readily available systems for sending text messages that would be much more effective are not in place at the state agencies charged with handling inquiries and outreach, Slonaker said.
A DHHS spokesperson told The Tribune that contracted health plans have been sending reminders to members via text message.
The native language may also have been a barrier for Utah residents needing to renew their Medicaid coverage. According to an analysis by the Kaiser Family Foundation, while Utah’s online Medicaid application is available in about 100 languages, its homepage and PDF application are only available in English and Spanish, and people answering phones at its call center they only speak english.
Another possible reason Medicaid recipients aren’t responding to mailers, Kevin Burt, assistant director of the Utah Department of Workforce Services, said at the legislative committee hearing, is that they have employer-sponsored coverage. .
Utah has had one of the lowest Medicaid policyholder rates in the country for years. About 11.3% of Utahns had Medicaid coverage in 2021, and in 2019, Utah was the only state with single-digit Medicaid coverage, at 9.7%.
According to estimates by the US Census Bureau using data between 2017 and 2021, approximately one in ten Utah people under the age of 65 have no health insurance at all. The public probably won’t know how that number changed during the unwinding of COVID-era continuous Medicaid coverage for another two years.
Slonaker said it’s important for the state to have strategies in place to make sure people who need health insurance have it, whether through Medicaid, the Children’s Health Insurance Program, the federal health insurance marketplace, or their own employer.
Individuals could face financial turmoil (from medical bills) … setting them back several years on their path to buying a home, on their path to rising up the economic ladder, Slonaker said. Health insurance is that great equalizer, if you have it.
What to do if you have Medicaid
Utah residents with Medicaid should ensure that the Utah Department of Workforce Services has their up-to-date address and contact information and check any mail from the state.
People who have already lost coverage have 90 days in which Medicaid will cover their bills retroactively and should renew their policy as soon as possible if they are eligible.
Those who need assistance figuring out what to do next can contact Utah Health Policy Projects Take Care Utah program, which offers assistance navigating and applying for insurance.
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