Breanna Reeves |
Millions of Californians are at risk of losing health coverage as state and federal COVID-19 public health emergencies (PHE) are set to expire.
During the pandemic, Californians enrolled in Medi-Cal – the state’s Medicaid program – were provided with “continuous coverage” that allowed them access to healthcare services without interruption. States received increased federal funding with the promise that they would postpone disenrollments as long as the PHE was in effect.
The “continuous coverage” is set to end on March 31 under the federal Consolidated Appropriations Act of 2023 which no longer upholds the Medicaid continuous coverage requirement. Beginning on April 1, 2023, counties across the state will begin the process of annual Medi-Cal renewals for all beneficiaries and redetermine their eligibility, a process the Centers for Medicare and Medicaid call “unwinding.” If they are no longer eligible or fail to complete the renewal process, coverage will be terminated.
Who’s at risk of losing coverage?
Roughly 91 million people were enrolled in Medicaid as of October 2022. Experts estimate that 18 million people are at risk of losing coverage as a result of the year-long unwinding process despite seven million still being eligible.
During an Ethnic Media Services media briefing on the unwinding process, Farah Erzouki, senior policy analyst at the Center on Budget and Policy Priorities (CBPP), explained that the Medicaid staffing crisis and paperwork issues will contribute to people losing coverage. Additionally, people who fail to submit paperwork on time or contact their Medicaid agencies will also be at risk of losing coverage.
“We know that procedural barriers or the red tape that people experience in trying to access Medicaid have deep roots in systemic racism,” Erzouki said. “People of color are disproportionately impacted by these procedural barriers and this makes it more difficult for them to enroll and stay enrolled in safety net programs like Medicaid, despite being eligible.”
In California, an estimated 15 million people — one-third of the state’s population — are enrolled in Medi-Cal and up to three million people could lose coverage if they fail to renew coverage or no longer qualify.
According to Erzouki, research predicts that of those receiving Medicaid coverage, 64% of Latinos, 50% of Asian Americans/Native Hawaiian/Pacific Islanders and 40% of Black beneficiaries could lose coverage compared to 17% of White enrollees. Nearly three in four children — 72% — are at risk of losing coverage under the Children’s Health Insurance Program (CHIP).
“The good news is that coverage loss is not inevitable,” Erzouki noted. “State agencies can and must act now to ensure that eligible communities have the information they need to stay covered and that people who are not eligible for Medicaid anymore can transition to another form of coverage.”
On Jan. 12, 2023, the Department of Health Care Services (DHCS) updated its operational plan for California’s unwinding process. The plan is divided into two key parts: the unwinding of Medi-Cal program flexibilities and resuming normal Medi-Cal operations.
In order to minimize red tape, “DHCS will maintain the Medi-Cal beneficiaries’ current renewal month in their case records and conduct a full redetermination at the next scheduled renewal month following the end of the continuous coverage requirement,” the plan states.
The plan also includes a two-phase communications strategy for the unwinding process. Phase one involves using DHCS Coverage Ambassadors to encourage beneficiaries to update their contact information with county offices via flyers, social media and website banners. In Phase two, ambassadors will remind beneficiaries to watch out for renewal packets in the mail.
What beneficiaries need to know:
Importance of updating address and contact information
Medicaid/Medi-Cal enrollees who have moved, changed address or have new contact information will need to update contact information with county offices. Residents who live in Riverside and San Bernardino Counties can find where to update their Medi-Cal information by visiting this website.
“[People] could receive their renewal notices at some point this year or early next year because remember, states will have about a year to initiate the renewals and so people could be on the earlier side of the renewal process or on the later side, so they should be alert to this,” explained Laura Guerra-Cardus, CBPP’s Director of State Medicaid Strategy, during the media briefing.
Beneficiary Notification
The U.S. Department of Health and Human Services (HHS) will provide at least a 60-day notice prior to the official end date. Every Medi-Cal beneficiary will receive notification regarding the annual renewal, but not every Medi-Cal beneficiary will receive an annual renewal packet because counties may renew their eligibility using available information and databases such as information from the Internal Revenue Service (IRS).
Residents will receive an initial notice in the mail, so officials recommend updating your address to ensure the document is sent to the correct location. The notice will come in a yellow envelope like the one shown below.
What happens if you are not automatically renewed
Medi-Cal members who are not automatically renewed will be sent a form requesting updated information, due within 60 days. The annual renewal packet will be mailed out, but that is not the only way an individual has to complete the annual renewal. According to the Department of Health Care Services (DHCS), the annual renewal can be completed by calling the local county office, online, email, in person or by mail.
What to expect when renewal packets are returned
Once residents complete and submit/return the renewal packet, the county will send a letter letting beneficiaries know if they still qualify for Medi-Cal coverage. If an individual loses their Medi-Cal coverage, they will get a notice in the mail and will have 90 days to contact their county social services office to give them the information needed to keep their benefits
Those who no longer qualify for Medi-Cal will be eligible for free or low-cost coverage through Covered California, the state’s online marketplace for health insurance.
The Black Voice News and IE Voice will continue to follow this story.