During the COVID pandemic public health emergency, Medicaid enrollment was frozen, which meant people couldn’t lose their coverage no matter what. But now, thousands of Alaskans are at risk of losing their benefits — many because of paperwork issues.
Medicaid is health insurance for low-income Americans and serves about a third of people in the state. The Centers for Medicare & Medicaid Services — or CMS — which oversees the program, flagged Alaska along with 15 other states for its long wait times and frequent hang-ups on phone help lines. The federal agency fears those problems will interfere with equitable access to the program. And CMS said that could put the state out of compliance with federal requirements.
Division of Public Assistance Director Deb Ethridge said the biggest issue they’re running into is people with old addresses on file. She said some people may not be up for renewal yet, so they shouldn’t worry if they haven’t gotten renewal paperwork in the mail. But everyone enrolled in Medicaid should have received a postcard; those were sent out in April.
“We did send a postcard out to every Medicaid household,” said Ethridge. “So a person who never saw a postcard come from the Division of Public Assistance, that might be a good hint that perhaps we don’t have your correct address.”
Because the renewals have been paused for so long, more people have experienced life changes that may affect coverage. And more people have moved to new addresses than usual. So, the department is processing extra paperwork. And that’s during a time when the office is still catching up from delays in distributing SNAP benefits.
Anyone whose address isn’t updated in the system and doesn’t receive their renewal paperwork may lose coverage even if they are still eligible. In July, the percentage of people who lost enrollment for procedural reasons in Alaska jumped by a third compared to May and June. So, Ethridge said her department is doing a “deep dive” to try to figure out what’s going wrong.
“We’re seeing anecdotally with my staff that people didn’t realize they were still on Medicaid and so that may be why they’re not returning the information,” said Ethridge.
Ethridge said the department is hiring more people to help with re-enrollment.
About a third of people up for renewal over the past three months have been automatically renewed without needing to fill out paperwork. But about another third were procedurally disenrolled. Those people may still be eligible for coverage, but Medicaid couldn’t automatically enroll them and they either didn’t fill out the required paperwork or didn’t get it in the mail.
In total, about 10,000 Alaskans who may still be eligible for the program have lost coverage since June.
Lisa Aquino, Anchorage Neighborhood Health Center CEO, said about half the center’s patients are on Medicaid. She has seen the confusion of the renewal process play out at her clinic.
“There are people that are finding out at really terrible times that they no longer have Medicaid,” said Aquino. “And it’s a surprise to them. And everyone’s trying to do their best to make sure that doesn’t happen, but the reality is that for some people, it is happening.”
Aquino said they are helping walk patients through this renewal process. Health care practitioners are able to access information about Medicaid coverage for their patients through a HIPAA-protected database.
Aquino said she wants people to know that there are options for health care, no matter their situation or income. But she’s concerned about the people who will fall through the cracks in this process.
“People who I’m maybe most worried about are people who are not connected with a regular health care provider, people that are experiencing homelessness or houselessness, people that don’t have an address,” said Aquino. “I’m worried about them.”
So far, the state has processed about 12% of renewals. About 225,000 more people will need to renew through the spring of next year.
If people want to check on the status of their coverage, there are several ways to do that. If they are part of a clinic or see a doctor, those practitioners can access their medical information and coverage. They can fill out this online survey. They can also call the help line at 800-478-7778. People answering phones there are trained to walk people through the renewal or address change process-but wait times are long. If people lose their coverage but want to appeal, they can request a fair hearing, which Ethridge said can take place online.
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Rachel Cassandra covers health and wellness for Alaska Public Media. Reach her atrcassandra@alaskapublic.org. Read more about Rachel here.
