Mar. 7—Beginning April 1, Maine and the rest of the nation will start shifting people who are no longer eligible for Medicaid to other forms of health insurance coverage.
During the pandemic, Medicaid recipients were allowed to keep their coverage even if they became ineligible. Some are no longer eligible because they now qualify for employer-based coverage, their wages have grown and they now are eligible for Affordable Care Act coverage, or they have reached 65 years of age and they are eligible for Medicare.
About 420,000 Mainers are expected to be receiving Medicaid in April.
Medicaid recipients who lost eligibility were allowed to remain enrolled during the COVID-19 pandemic to make sure there were no gaps in health coverage. But with the pandemic easing, Congress approved an omnibus spending bill last year that requires states to update their Medicaid rolls. States must now ensure that people who no longer qualify are not still receiving the coverage.
Maine estimates that 65,000 to 90,000 people who are ineligible now, or will be within a year, are still receiving Medicaid. Medicaid — called MaineCare in Maine — is insurance for low-income residents funded with a combination of federal and state dollars.
Jeanne Lambrew, Maine's health and human services commissioner, said in a news conference Tuesday that many people may not realize they are no longer eligible. The state is setting up the "Stay Connected to Stay Covered" campaign to help people switch to other health insurance. A website called MyMaineConnection.gov provides information, and people can also call 855-797-4357 for assistance.
In addition, the Maine Department of Health and Human Services will be mailing reminders to people on a rolling basis, based on the month they originally signed up for MaineCare. Enrollees who receive a mailer from MaineCare with a blue block image will know it is the form to either renew or to determine if they need to find other insurance.
"Our goal is to make this as easy as possible," Lambrew said.
Ann Woloson, executive director of Consumers for Affordable Health Care, which is partnering with DHHS to ensure Mainers maintain health coverage, said the agency "is taking steps and making a good effort to inform people that they will need to update their contact information and also will need to update their MaineCare eligibility information."
Mainers are eligible for MaineCare if they earn up to 133% of the federal poverty level. Those who earn more will qualify for Affordable Care Act plans — those just over the MaineCare eligibility threshold can often get ACA plans with premiums of less than $25 per month.
Lambrew said it's unclear what percentage of the 65,000 to 90,000 will migrate to ACA plans or employer-based plans. But once everyone shifts to plans they qualify for, there should be relatively few uninsured Maine residents.
Maine's uninsured rate declined from 8% before the state expanded Medicaid in 2019 to 5.7% in 2022, according to the U.S. Census. Some people remain uninsured because they choose to do so, or simply because they neglect to sign up for Medicaid or an ACA plan even though they qualify.