Urban: Majority surveyed not aware of looming Medicaid eligibility redeterminations

A recent survey of adults found more than 60% are not aware their eligibility for Medicaid could be in danger, underscoring the massive task states and managed care plans face ahead of an April 1 deadline. 

The analysis, published Thursday by the Robert Wood Johnson Foundation, looks at the awareness of the looming Medicaid eligibility redeterminations at the end of 2022. The survey, conducted by the think tank Urban Institute, showed awareness was lacking across the country regardless of the area. 

“States and the federal government must quickly raise awareness that many families will soon need to take steps to maintain or find new health coverage,” said Gina Hijjawi, senior program officer for the foundation.

Researchers gleaned the results from Medicaid beneficiaries surveyed in the December 2022 Well-Being and Basic Needs Survey, which surveys more than 8,000 adults every year on how they are meeting basic needs such as food and medical care.

The results showed that 64.3% of Medicaid beneficiaries surveyed weren’t aware of the looming renewal process, virtually unchanged from a similar analysis back in June that found 62% of adults were not aware. 

It found that 16% of adults were only a little aware of the eligibility redeterminations, 13.9% were somewhat aware and 5.1% were very aware.

States, managed care plans and other stakeholders have been bracing for the start of Medicaid eligibility redeterminations since the onset of the COVID-19 pandemic.

Back in 2020, states agreed to a boosted federal matching rate for Medicaid payments in exchange for not enrolling anyone off Medicaid for the duration of the COVID-19 public health emergency (PHE). After the emergency ends, the states have to redetermine eligibility for every Medicaid beneficiary. 

The federal government has kept the PHE going for three years, but it is now set to let it expire in May. 

A potential reason awareness has been stubbornly low may be the ambiguous timing of the PHE, which the Department of Health and Human Services has renewed for 90 days at a time.

“We have heard that some states were not notifying people about the requirement because it was so uncertain,” Jennifer Haley, a principal research associate for Urban, told Fierce Healthcare in an interview. “I think that has been part of the challenges for folks is just states didn’t really know what to say to inform people.”

Now, states have a set deadline of April 1 to kick-start redeterminations, a deadline included in a spending package passed at the end of last year.

Haley hopes states use a direct approach to reaching out to consumers and increasing awareness. 

“For those people who heard directly about the return to renewals either from their state or health plan, only about 1 in 5 got information about consumer assistance,” she said. “Given the importance, we know that type of assistance is for people suggested it will be critical to make that connection to other organizations that can help.”

Those other connections are going to be critical, as some beneficiaries will not be eligible for Medicaid after the redetermination process and will need to be steered toward other coverage sources such as the Affordable Care Act’s insurance exchanges, Haley added.