Medicaid rules will change soon. See how it will impact folks in Morgan, Lawrence and Owen counties
Medicaid rules will be changing soon, removing the freeze the COVID-19 pandemic era has on certain requirements. Experts and advocates are urging people to get prepared now.
COVID's Impact
At the onset of the pandemic, the federal government enacted a state of public health emergency, which remains in place today. As a result of that emergency, certain Medicaid rules were paused.
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Premiums and copays were suspended, the state was able to verify people's income information without having to rely solely on the applicant, and annual redeterminations did not occur.
This has caused Medicaid enrollment to swell. There are currently over 2 million Hoosiers enrolled in some form of Medicaid across the state. That is almost a third of the state's population.
The Healthy Indiana Plan, or H.I.P., is the program that grew the most during the pandemic, according to IUPUI professor and researcher David Craig.
Through his work at the university, Craig tries to spread awareness about H.I.P. and other health resources to his students and the religious congregations they work with for projects.
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H.I.P. is a multi-tiered Medicaid expansion program that serves low-income adults between the ages of 18 and 64. According to Craig, H.I.P.'s statewide enrollment numbers have shot up by 75% over the course of the pandemic, from 400,000 to 750,000.
Over 7,200 of those enrollees live in Morgan County, as of a May 2022 report from the Indiana Family and Social Services Administration. In Owen County, there were more than 2,800 recipients while Lawrence County had over 5,400 enrollees.
Going Back to Normal
Once the federal government ends its public health emergency, states will begin to return Medicaid to its pre-pandemic manner. This means that not only will premiums and copays return for H.I.P. and other programs, but also a restart the redetermination process for all enrollees.
Craig says that some people losing coverage is inevitable because they no longer qualify for H.I.P. But his concern is for new enrollees or those that have forgotten how things used to operate.
"You're gonna have 700,000 (H.I.P. enrollees) hit with rules they may never have experienced before or they may have forgotten," Craig said. "And if they don't follow the rules, they're gonna lose coverage."
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Currently, the emergency is scheduled to end on July 15. The federal government is supposed to offer a 60-day warning before officially ending the emergency, though, which has not occurred. In light of this, Craig says the federal government will likely be granting the emergency another three-month extension.
When the emergency does eventually end, the federal government will grant states a period of 14 months to fully transition Medicaid back to normal. The state has not yet detailed a full transition plan, but time is something that Indiana has said it will take full advantage of.
Unlike neighboring Ohio, which is going back to normal in just 90 days, Indiana has said it will take all 14 months to work through redetermination for all enrollees, according to Susan Jo Thomas, executive director of Covering Kids & Families of Indiana.
Thomas says the state will start the redetermination process with healthier, able-bodied individuals first. She says that means enrollees in H.I.P. are likely the first in line, since those individuals are the ones H.I.P. helps the most.
Those who are disabled, elderly, chronically ill, or pregnant will come later in the process. Pregnant women will continue to get coverage for a year after they give birth.
"I'm very proud of our state for doing something that's more public health-focused than financially focused," Thomas says.
What You Need to Do
Craig and Thomas both advise using the remaining time of the public health emergency to get ready for the eventual redetermination.
The FSSA has an online benefits portal that enrollees can use to see what information they need to submit. Through that portal, enrollees can update their mailing address, contact information, and preferred method of contact.
Craig advises to make sure your address is correct so you receive the physical mail redetermination notice, particularly if you have moved in the last couple of years.
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"The big concern right now is the state is gonna be asking people to provide annual renewal information [and] people aren't gonna get the message," Craig says. "People may not even know about annual renewal because they (first) joined during COVID and they never had to do this."
Craig says his best advice is to contact a certified navigator to help you. Navigators, like those that work at Thomas' Covering Kids and Families, know the ins and outs of the healthcare system and can help walk you through technical questions.
"You literally have to be well-educated and extremely familiar with (healthcare coverage) in order to do this," Thomas says. "You need an expert to help you."
The FFSA provides a county-by-county list of navigators on its website.
Should We Go Back to Normal?
Getting back to the way things used to be has been a big theme of the last several months by dropping the masks, returning to in-person work, gathering with friends again. But both Craig and Thomas question if Medicaid should be on that list.
Thomas describes some of the rules meant to gatekeep Medicaid as "hard and pretty much ruthless."
Craig says that the ballooning in enrollment observed in H.I.P. "suggests that some of the growth is (from) having had a hard time navigating the rules in the past." He described monthly premiums as "a barrier to a lot of people."
Information gathering is another area Thomas says would be better if it could stay as it is. During the pandemic, if the state could verify information by referencing the information they already had in other databases, they could do so.
"It was really awesome," Thomas says. "We wish they would do it that way all the time."
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Thomas says that the pandemic simplified the process and made Medicaid more accessible.
"There are other ways to get people on benefits without putting them through these terribly-hard processes," Thomas added.
This article originally appeared on The Reporter Times: Medicaid rules changing soon. See how it will impact those in need
