Urban Institute: Most adults unaware of looming Medicaid eligibility redeterminations

Most of the adults in families that have Medicaid are not aware that their future eligibility could be in jeopardy after the COVID-19 public health emergency (PHE) ends.

The new findings from the Robert Wood Johnson Foundation underscore the monumental task states have ahead of them in redetermining the eligibility of their entire Medicaid populations.

“When the public health emergency ends, millions of enrollees risk losing their Medicaid coverage due to administrative churn, even if they remain eligible,” said Katherine Hempstead, the foundation’s senior policy adviser, in a statement. “Low awareness among enrollees compounds the problem.”

The analysis, conducted by the think tank Urban Institute and released Wednesday, relied on data from a June 2022 survey. 

It showed that 62% of adults with family Medicaid enrollment were not aware of the looming redeterminations after the expiration of the PHE, which is likely to be extended into spring 2023. Urban found that only 5% of respondents had heard a lot about the redeterminations, followed by 16.2% who heard some and 15.7% who heard only a little. 

Among the 37% who heard at least a little about the resumption, the most common source was from the media, followed by 30% from a state agency and another 24.5% from their insurer. 

The findings spotlight the problem states have as they continue to prepare for the end of the PHE, which currently runs through January. The Department of Health and Human Services has promised to give stakeholders a 60-day notice when the PHE will not be renewed for another 90-day period, with such a deadline passing earlier this month. This means the PHE will likely be in place through April.

At the start of the pandemic, Congress approved a boost to the federal matching rate for Medicaid payments to states. However, the state could only get the boost if they agreed to not drop anyone off their Medicaid rolls for the duration of the PHE. 

Once the PHE ends, states will have 14 months to redetermine the eligibility of anyone on Medicaid. States have been working for months to prepare for the end of the PHE, including increasing outreach to beneficiaries to make them aware of the redeterminations. 

Urban found that of the people who heard about redeterminations from their state agency, the most common source was a notification about the need to renew their coverage.

States have been trying to find ways to reach beneficiaries beyond just mail notices, including via text messages.

The analysis said Medicaid agencies could prepare now to renew some enrollees’ coverage automatically. This can ensure that people who continue to remain eligible don’t unnecessarily lose their coverage and “link those who need it to other affordable coverage options,” said Jennifer Haley, senior research associate for Urban, in a statement.

The end of the PHE could bring with it a major upheaval in insurance coverage. An analysis from the Kaiser Family Foundation released earlier this year predicted that between 5.3 million and 14 million people could lose Medicaid coverage due to the redeterminations.