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Medicaid Redetermination: In One State, Many Didn't Renew

  • January 9th, 2024

Senior couple on Medicaid at home looking at laptop together in confusion.Results of a recent survey led by the Department of Health and Human Services in Utah reveal that more than half of the state’s residents who lost their coverage during Medicaid’s “unwinding” process in 2023 did not attempt to resecure their benefits.

What Is Medicaid?

Medicaid is a federal program that serves Americans with limited income, providing health insurance for seniors, people with disabilities, and other populations. To be eligible for Medicaid benefits, you generally must have no more than $2,000 in cash assets. Each state runs its own Medicaid program, so many of the other rules and benefits of the program tend to vary widely depending on where you live.

Medicaid Redetermination and the COVID-19 Public Health Emergency

Traditionally, Medicaid agencies in each state review their list of current enrollees on a periodic basis to determine who no longer qualified for benefits. These agencies may disenroll people if, for example, their income has exceeded the asset limit. Prior to the COVID-19 pandemic, the expectation under this re-evaluation process was that enrollees would report any changes to their income or other relevant circumstances that could affect their ability to qualify for Medicaid.

When the pandemic struck, the federal government put a pause on this so-called Medicaid redetermination process. This prevented states from removing any Medicaid recipients from their books. As a result, more than 20 million people were able to receive Medicaid benefits on a continuous basis during the pandemic.

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Many who received Medicaid during this time did not realize that, once the COVID-19 Public Health Emergency expired in the spring of 2023, Medicaid agencies would return to their customary practice of reassessing enrollees to determine who was still eligible for Medicaid coverage.

(Check to see whether your state’s Medicaid agency has completed its Medicaid redetermination process.) Many Medicaid recipients also were not aware that they may have had to apply to renew their coverage.

Confusing Processes May Deter Renewals

According to survey participants, state agencies most commonly have disenrolled them from Medicaid because their income had become too high to qualify for the program. Yet, as the findings suggest, Medicaid recipients consider the processes to apply and to renew confusing. In fact, more than half – 57 percent – reported that they had not tried to renew their Medicaid coverage. Fifty percent of survey participants said this was because they found the renewal process difficult, while 44 percent found it difficult to review and fill out the Medicaid forms.

Nearly one-third of respondents said they ended up without any insurance coverage after they lost Medicaid. More than half reported they had minor children living in their home who had been receiving these benefits. As Kaiser Family Foundation (KFF) reports, experts are concerned about individuals who may have lost access to care or seen their medical bills pile up.

In Utah, this is of particular concern because data shows that Utah is among the top three states in the country where people had lost their Medicaid coverage because of procedural reasons. Disenrollment for procedural reasons can happen when a state has out-of-date information on its enrollees or took too long to process a recipient’s renewal paperwork.

Of those who did attempt to reapply, almost three-quarters of them discovered they were no longer eligible, according to their state agency.

More than 1,000 residents of the Beehive State who were former Medicaid recipients took part in the survey.

Renew Medicaid: Consult an Elder Law Attorney

The steps you need to take to qualify or apply for Medicaid can be daunting. If you have lost your Medicaid coverage or don’t feel comfortable navigating the application or renewal process, reach out to a qualified elder law attorney near you today. They will have the necessary expertise on the Medicaid rules specific to the state in which you live. You also can contact your state’s Medicaid agency or your local State Health Insurance Program (SHIP) for guidance.

In addition, you may find reading the following articles on Medicaid renewals insightful:


Created date: 01/09/2024
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