Virginians could lose access to Medicaid as eligibility gets reexamined. But how many is ‘a very big unknown.’

Virginia Medicaid rolls have swelled from around 1.5 million to over 2 million people since the COVID-19 public health emergency began in March 2020.

As part of a federal bill from that month, states could not remove anyone from their rolls.

But as the country transitions out of the early pandemic phase and the public health emergency comes to an end, the Virginia Department of Medical Assistance Services will reexamine who is eligible to remain on the rolls. Every one of those 2 million members will have to be evaluated to see if they are still eligible for Medicare coverage over a 12-month period. And various health groups do not have an idea of exactly how many Virginians will lose access to Medicaid.

The public health emergency has been extended in the past and its next expiration date was set for July 15. Agencies such as the Virginia Department of Medical Assistance Services, which runs Virginia Medicaid, are slated to receive a 60-day notice prior, according to Sarah Hatton, deputy of administration.

“We don’t know exactly when the emergency status will end,” she said.

DMAS staff have been planning for the review because they understood the scale of reviewing how many Virginians on rolls remain eligible, after a long period without review, Hatton said. Typically, the state department conducts a review for Medicaid eligibility every year.

“We realized there was going to be a need to be ready for a large scale redetermination process,” Hatton said.

The federal government allocated an increased 6.2% match through the public health emergency to support state Medicaid services, Hatton said. In Virginia, this has resulted in $1.2 billion in additional funding, offsetting the increased costs of more Virginia Medicaid participants, according to Hatton.

There are only two reasons someone could have been removed from Medicaid rolls since March 2020: they moved out of the state or they reported they no longer needed Medicaid coverage, Hatton said.

The department has been working with other groups, including Sentara and community health groups, such as the Virginia Association of Free and Charitable Clinics. The department launched social media ads in April and radio and TV ads will start to be released in phases, Hatton said. Spanish language ads are included.

“We expect that a fair number of people through this process of redetermination will no longer be covered by Medicaid for various reasons and some of those may be become uninsured,” said Rufus Phillips, chief executive officer of the VAFCC.

Phillips and Hatton said situations that would make Virginians no longer eligible for Medicaid coverage include obtaining a job that offers health insurance or being able to afford insurance on the federal exchange.

Yet, there will be some people who may lose coverage altogether, according to Phillips. He said Medicaid members should update their contact information so they can be easily contacted to ensure they are still eligible for Medicaid coverage.

“If that is not up to date, they’re not going to get the application form to fill out for the determination process,” Phillips said.

He said VAFCC member clinics are pushing to spread the word about how important it is for Medicaid members to update contact information, even before a date is assured for the end of the public health emergency. And for those who fall through the cracks, free and charity clinics will be available for services, Phillips said.

Sentara is also working with DMAS to ensure those who are no longer eligible for Medicaid are able to receive care, according to a statement from Patti Darnley, senior vice president of government programs for Sentara Health Plans.

Like the clinics, Sentara is working to verify contact information for patients who are Medicaid members and will help them with questions and other issues during the eligibility evaluation, according to the statement.

“For members who lose their Medicaid eligibility, we will offer coverage though our individual and family exchange products to ensure that they have the same access to quality providers within our integrated delivery network,” the statement said. “This will allow members, in many cases, to continue their relationships with their care managers and have access to the same excellent customer experiences that they received while covered by our Medicaid plans.”

Bon Secours, another large medical provider, will reach also out to the community and its patients to spread the word when an end date is finalized, according to Marlene Capps, interim chief clinical officer for Bon Secours Hampton Roads.

Like the other health leaders, she said it is still too early to tell exactly how many people will be affected.

“I think that’s a very big unknown,” she said. “I don’t think anyone knows that number yet.”

Yet, it is still imperative that care is available for Virginians as COVID-19 will remain a hazard even as the public health emergency ostensibly ends, according to Capps.

“We want to make sure our most vulnerable populations continue to be covered as we enter the next phase,” she said.

Ian Munro, ian.munro@virginiamedia.com