Approaching ‘Medicaid cliff’ could leave hundreds of thousands uninsured
Send a link to a friend
[February 09, 2023]
By PETER HANCOCK
Capitol News Illinois
phancock@capitolnewsillinois.com
SPRINGFIELD – As many as 700,000 Illinoisans may stand to lose their
Medicaid coverage after March 31, but the Department of Healthcare and
Family Services says it is working to reduce that number and help those
affected find health insurance elsewhere.
Medicaid is a health insurance program for poor and disabled people that
is jointly funded by the federal government and the states.
The coverage “cliff,” as some have called it, is the result of a
spending bill that Congress passed in December. It puts an end to a
pandemic-era rule that sent billions of additional federal dollars to
states if they agreed to keep Medicaid patients continuously enrolled in
the program through the end of the public health emergency without
having to go through the normal reapplication process.
Because that law separated the Medicaid rules from other emergency
actions, the program will end sooner than the May 11 date on which both
the White House and Gov. JB Pritzker plan to end their emergency
declarations.
The change means many who have been receiving continuous Medicaid
coverage throughout the pandemic will have to reapply for benefits,
potentially leading to loss of coverage if the individual would no
longer qualify for benefits or if they fail to complete a reapplication.
Nationwide, the federal government estimates that 15 million people, or
17.4 percent of Medicaid and Children’s Health Insurance Program
enrollees, will lose their coverage as a result of ending the continuous
enrollment program. That would translate to roughly 700,000 people in
Illinois if it follows the national pattern, but DHFS officials believe
they can mitigate the impact of the rule change.
“At the state level, we estimate a total of roughly 384,000 will lose
coverage because we believe in doing everything we can to help eligible
Medicaid customers keep their benefits,” DHFS spokesperson Jamie Munks
said in an email. “The truth is, nobody knows for sure. What we do know
is that we are committed to ensuring everyone who is eligible maintains
their coverage, and that those who are not are given information about
alternative coverage.”
![](http://archives.lincolndailynews.com/2023/Feb/09/images/ads/current/charrons_bch_2022.png)
To avoid losing coverage, DHFS strongly urges Medicaid enrollees to fill
out their renewal forms as soon as possible. The agency will resume
regular verifications starting in late April, and people with a June
renewal date will be the first ones to go through the restarted process.
Those people will need to submit their renewal forms before June 1 so
they can maintain coverage without disruption.
Munks said Illinois has been preparing for the eventual end of
continuous coverage for months and has been communicating with Medicaid
beneficiaries about the importance of updating their contact information
on file with the Medicaid program.
[to top of second column]
|
![](http://archives.lincolndailynews.com/2023/Feb/09/images/ads/current/graue_lda_ENVISIONpreowned_020723.jpg)
“The state has and continues to increase customer service staff and
enhance our systems,” she said.
Munks said customers can complete their renewal by phone, although
online is the preferred method.
The agency will try to reach affected individuals by mail, email, text
messaging, phone calls and paid advertising, she said. It will also work
with partner providers, advocacy organizations, nonprofits and other
government entities, she added.
Munks said people who are found to be ineligible may still have other
options for low-cost insurance, including individual plans sold through
the Affordable Care Act marketplace, which operates in Illinois under
the name Get Covered Illinois. People who meet certain income guidelines
can receive tax credits to pay all or part of their premiums.
![](http://archives.lincolndailynews.com/2023/Feb/09/images/ads/current/castlemanor_sda_FINANCIAL_2017.png)
Who is most affected?
Throughout the pandemic, people who were enrolled in Medicaid did not
have to go through the normal process of reapplying every 12 months to
determine whether they were eligible, even if there were changes in
their income or household that would normally make them ineligible.
DHFS says that Illinois’ Medicaid enrollment grew by about 1 million
enrollees during that period, to 3.9 million. But the state also
received an additional $3 billion in federal funding through the
enhanced matching rate.
The U.S. Department of Health and Human Services estimates that when the
continuous enrollment program ends, about 9.5 percent of Medicaid
enrollees nationwide, or 8.2 million people, will lose coverage because
they are no longer eligible. The most common reasons for losing
eligibility are changes in income or household makeup or moving out of
the state in which they were covered.
But another 7.9 percent, or 6.8 million people, will lose coverage
despite still being eligible for Medicaid because they don’t complete
their applications properly or the state is somehow unable to process
the application – a process called “administrative churning.”
Children and young adults, ages 18-34, make up the largest categories of
people expected to lose coverage. The change is also expected to
disproportionately affect the Latino community, which makes up one
quarter of those predicted to be ineligible and one-third of those
expected to experience churning.
Black individuals make up 14 percent of those expected to lose Medicaid
eligibility and 15 percent of those expected to experience churning.
Capitol News Illinois is a nonprofit, nonpartisan news
service covering state government. It is distributed to more than 400
newspapers statewide, as well as hundreds of radio and TV stations. It
is funded primarily by the Illinois Press Foundation and the Robert R.
McCormick Foundation. |