In the first two months of resumed checks for Medicaid eligibility, almost half of Ky. members up for renewal lost their coverage

By Melissa Patrick

Kentucky Health News

The end of the pandemic meant resumption of eligibility verification for Medicaid, and almost half of the Kentuckians who have been asked to renew their Medicaid coverage in the first two months of verification have lost it, mainly because they did not respond.

 

Of the 153,386 people asked to renew so far, nearly 34 percent didn't respond, and 46 percent of the total were terminated for that or other reasons, according to state data.

Priscilla Easterling, outreach coordinator for Kentucky Voices for Health, called the number of terminations and the number of people who have not responded to a renewal request "worrisome." 

More than 52,000 "of these terminations were for procedural reasons; people simply did not reply to those notices requesting information, and that's scary," she said. "These aren't folks who were determined ineligible. We don't know if they're ineligible. They didn't reply to a notice, and so they lost their coverage." But Easterling cautioned that it's too early to call it a trend. 

The state Department for Medicaid Services resumed its annual renewal process for Medicaid members in April because the pandemic rules that allowed for continuous enrollment ended. In April, Kentucky had 1.7 million people on its Medicaid rolls. 

The process that allows state Medicaid agencies to restart the annual renewals or kick off those who no longer qualify has been dubbed the "Medicaid unwinding," a process that will take 12 months to complete in Kentucky; each Medicaid beneficiary has a renewal month.

During the renewal process, Medicaid members are getting a notice of eligibility, a renewal packet or a request for more information. 

May was the first renewal month. Of the 74,004 individual renewals that were due May 31, state data shows 37,779, or 51% of them, were approved and 33,794, or nearly 46%, were terminated. And despite multiple notices, calls, texts and emails from the state, 23,756, or 32%, did not respond.

The non-response rate rose in June, when 79,382 individual renewals were due. The state says 40,333, or nearly 51%, were approved; 37,140, or nearly 47%, were terminated; and 28,281, or nearly 36%, did not respond. 

The report also notes that of the 33,794 Kentuckians who were terminated in May, 5,808 of them were eligible for a federally subsidized or "qualified" health plan through Kynect, the state-based marketplace for health insurance. Of those, only 465, or 8%, enrolled in a qualified plan. 

That rate increased in June to 10.9%. Of the 37,140 Kentuckians who were terminated that month, the report says 5,142 would qualify for a qualified plan, and 559 of them enrolled in one.

Easterling said there is a concern that people who have not responded won't realize they don't have coverage until they seek treatment and learn they are no longer on Medicaid. If that happens, she said a person has 90 days after their loss of coverage to be reconsidered. 

She also encouraged people to not assume they don't qualify, especially if they have children, because it's easier for children to qualify.  

Easterling said it's not clear why so many Kentuckians have not responded to renewal requests, so it's important for people on Medicaid to visit their account at kynect.ky.gov and make sure their address and income information are up to date. She encouraged Kentuckians who need help to reach out to a "Kynector," who can answer questions and help you understand your coverage options. 

Managed-care organizations, mostly health-insurance company subsidiaries, which manage the care of Medicaid beneficaries, are also working to help Kentuckians with the renewal process. 

"MCOs are engaged in extensive outreach to capture the most up-to-date contact info for the state and providing referrals for other sources of coverage when necessary," Tyler Glick, Kentucky Association of Health Plans spokesman, said in an email. "In addition, MCOs are partnering with hyperlocal organizations to distribute renewal kits and host workshops to assist plan members with the redetermination process. The goal is continuous coverage, whether in Medicaid, via employer-provided coverage, or through Kynect with a qualified health plan or other options." 

As an example, the Northern Kentucky Tribune reports that one of the ways Anthem Kentucky Medicaid is joining with local agencies across the state to help its members redetermine their Medicaid eligibility by asking them to remember a simple acronym, ACT, which stands for: 

• Address — make sure kynect.ky.gov has your correct mailing and email address, along with your phone number.
• Check mail — you may receive a letter about your Medicaid or Kentucky Children's Health Insurance Plan renewal letting you know that you need to complete a redetermination form to maintain your coverage.
• Turn the form in — if you get the form, fill it out and return it right away. This may help you avoid losing Medicaid or KCHIP.