More than 500,000 Medicaid recipients at risk of losing coverage once eligibility verification resumes

Sep. 30—Federal regulations that prohibited the state from disenrolling residents from Medicaid are expected to soon expire, putting more than 500,000 recipients at risk of losing coverage, according to the state Department of Human Services.

The program, which provides health care benefits to low-income residents, temporarily halted the periodic verification process enrollees must complete to determine if they remain eligible for benefits. It did so as a condition of accepting additional Medicaid funding under the Families First Coronavirus Response Act, which barred states from disenrolling anyone while the COVID-19 public health emergency is in effect.

The federal government has not yet notified states when the health emergency declaration will end, but officials expect that will occur by the end of this year, acting DHS Secretary Meg Snead said during a visit to the Scranton Primary Health Care Center on Thursday.

As of July, DHS identified 525,000 enrollees now receiving benefits who no longer meet eligibility requirements, said spokesman Brandon Cwalina. Another 314,000 cases have not completed the renewal process since the health emergency was put in place, he said.

Snead, joined by state Sen. Marty Flynn, D-22, Dunmore, and state Rep. Thom Welby, D-113, Scranton, stopped by the center to discuss the impact of Gov. Tom Wolf's 2015 decision to expand eligibility for Medicaid coverage as part of the Affordable Care Act.

The expansion today allows 1 million more residents to access care, Snead said. Since 2015, about 2.5 million residents had received coverage at some point because of the expansion. That helped reduce the uninsured rate from 8.5% in 2014 to 5.5% in 2021, she said.

That was particularly critical during the height of the pandemic, when many people lost their jobs through no fault of their own, she said.

"The Medicaid expansion is a lifeline when people need it most," she said.

Kathryn Kelly, 46, of Clarks Summit, is among local residents who benefited from the expansion. She works part time and is not eligible for coverage with her employer.

"I really didn't know what I was going to do and then I found out about this," she said. "I take monthly medications. ... Without this program, I'm not sure how I would manage that."

Snead said DHS is working with the state Insurance Department to help ensure that people who lose coverage once the health emergency declaration ends know about other options they have, including seeking coverage through health plans under the Affordable Care Act.

"It won't be an overnight thing that people will lose access to their benefits," she said. "We are working really closely with the Insurance Department to make sure ... no one falls through the gaps."

Contact the writer:

tbesecker@timesshamrock.com; 570-348-9137; @tmbeseckerTT on Twitter.

Advertisement