2 in 5 Colorado residents lost Medicaid coverage at first screening since COVID

More than two-fifths of the 120,000 Colorado residents whose Medicaid coverage had to be renewed in May lost their coverage when their eligibility was reviewed for the first time since early 2020 — a finding consistent with what happened before the pandemic.

The Colorado Department of Health Care Policy and Financing reported Wednesday that 56% of those assessed for eligibility in the first month were able to remain covered by Medicaid, while 42% lost coverage and the remainder were still in the process.

The numbers are nearly identical to the averages of 57% and 41% from 2018 and 2019, when the state last implemented regular Medicaid withdrawals, said Kim Bimestefer, the department’s executive director.

For much of the pandemic, states have not been able to withdraw most people from Medicaid due to the federal health emergency. Congress decoupled those two provisions late last year, and states began reassessing eligibility in April. The new determinations are made on an ongoing basis, with people who registered in July of a previous year being evaluated in that month.

One difference is that the percentage of people who were exmatriculated for not returning the paperwork was higher than before the pandemic, Bimestefer said. About 26% did not return the paperwork in May, compared to an average of 12% in 2018 and 2019.

It’s not clear how many of these people are still eligible and haven’t understood that they must return their paperwork to maintain their insurance coverage, compared to the number who accepted jobs where they were offered health insurance and were not responded because they no longer need Medicaid. said Bimestefer. When people no longer need insurance coverage, it would be helpful if they reported it to the state so staff doing outreach know not to call those members, she said.

“We don’t want to waste valuable resources on those who are already insured,” she said.

Earlier this year, the department estimated that 325,000 people in Colorado could lose their insurance because their income has increased too much to qualify for Medicaid, they have moved out of state, or they have exhausted their one-year postpartum coverage. Approximately 53,000 people lost their insurance coverage in the first month or during reassessments.

Some people who ignored the initial messages are likely to re-enrol later this year after learning they’ve been de-registered, Bimestefer said. While it’s better not to have a coverage gap, those who find that they are no longer covered if they seek care can fill out an application the same day that will cover them retroactively to the date of filing, provided they still have it are entitled. She said.

As of May, Colorado had about 1.7 million people enrolled in Medicaid, an increase of about 500,000 from before the pandemic. Enrollments also rose sharply across the country, with approximately 23.3 million more people enrolled in Medicaid and/or the children’s health insurance program in March 2023 than in February 2020.

The first month of rescheduling went as expected, but the state will review its data and hold focus groups to see if any tweaks could improve results, Bimestefer said. Individuals can help by updating their contact information on the state’s website and checking their coverage options, she said. Even if the adult members of a household are no longer entitled due to an increase in income, children can still be entitled to Children’s Health Insurance Plus.

“It’s where we thought (the numbers would be) but it’s not where we want it to be,” she said.

“A more difficult process” than anyone wanted

In early March, the Kaiser Family Foundation estimated that between 5.3 and 14.2 million people could lose their Medicaid or CHIP coverage over the next year. Nationwide, more than 1 million people have lost their insurance coverage.

Scammers have seen an opportunity in continuing to enroll people by calling or texting them and threatening to have their health insurance canceled if they don’t give out money or personal information. The state Medicaid agency will not ask for your Social Security number or your bank or credit card information over the phone.

Gretchen McGinnis, Colorado Access’s senior vice president of health systems and responsible care, said as of early June there were about 25,000 fewer people in her area covered by Medicaid than in early May. Colorado Access manages care for approximately 600,000 Medicaid recipients in Denver, Adams, Arapahoe, Douglas and Elbert counties.

It’s not clear how many of those people are ineligible because they left the state or earned too much, McGinnis said. It is also possible that some moved to one county and were assigned to another organization. Management organizations and the department are working to improve data collection so they can better track where members have ended up, she said.

McGinnis estimated about 37,000 homes were successfully contacted, but she couldn’t say how many she was unable to reach. Community organizations and healthcare providers are also coming forward, she said.

“We hope that (members) will receive multiple types of communication that keep them aware of this issue,” she said.

Patrick Gordon, CEO of Rocky Mountain Health Plans, said the company administers Medicaid insurance for about 255,000 people in western Colorado. While reassessing eligibility was a common practice before the pandemic, it will now be more of a challenge because newer recipients have never gone through the process and may not understand what they need to prove, he said.

“We’ve never done that before. Nobody did that,” he said.

In May, the process of automatically verifying eligibility appeared to be going smoothly, Gordon said. If they can’t determine if someone qualifies from other data collected by the state, they send out an extension packet and try other communication methods if the packet is undeliverable, he said.

The state has been planning this for some time and so far there have been no major surprises, Gordon said. Unfortunately, however, many people still don’t seem to be aware that they need to update their contact information with the state and take other steps to stay covered, he said.

“We want to make sure that a year from now we don’t have people struggling with unpaid medical bills,” he said.

McGinnis said proving eligibility for public utility programs has always been a relatively “awkward” experience compared to most things people do online. What makes it particularly challenging is the sheer number of people who will need to prove their eligibility over the next year, she said.

“I think it’s a more difficult process than any of us would have liked,” she said.

Most people in Colorado who lose Medicaid coverage would be eligible for subsidized health insurance through the marketplace, although it’s not clear how many will complete the process. According to the Kaiser Family Foundation, about 65% of people who opted out of Medicaid or CHIP nationwide before the pandemic were uninsured for at least a short period of time, and 17% said they were uninsured for at least a year afterward.

Some people may also soon return to Medicaid if their household income fluctuates. Before the pandemic, about 41% of people who opted out of Medicaid or CHIP re-enrolled within a year.

Colorado’s cut-off rate was the 13th highest

States report their numbers differently, making comparisons difficult, but there are notable outliers.

South Carolina has removed coverage for more than 80% of Medicaid beneficiaries verified to date, while Virginia has removed coverage for only 16%. Eight states reported that more than 80% of their deregistrations were for procedural reasons, while in Alaska only 15% of the cases were.

The Kaiser Family Foundation compared the states and found that Colorado’s cut-off rate was the thirteenth highest of 24 states that had reported their eligibility data. (The foundation estimated that 44% of Colorado residents surveyed had lost their insurance coverage, which was slightly higher than state figures showed.)