Medicaid in SC added 300K people during COVID pandemic. Many could lose benefits this year

An estimated 300,000 South Carolina Medicaid recipients could lose their health coverage over the next year as the the state agency that administers Medicaid begins reviewing recipients’ eligibility.

South Carolina Health and Human Services in April will be required to restart annual eligibility reviews to make sure people on Medicaid qualify for the health insurance benefit.

This is the latest move as the country moves on from COVID-era restrictions and assistance.

President Joe Biden on Monday announced the federal COVID-19 public health emergency also would come to an end in May.

The Families First Coronavirus Response Act, passed in early 2020, provided additional federal money for Medicaid to help states cope with the COVID-19 pandemic. The COVID package also prevented states from removing someone from Medicaid, a health insurance program run by states for low-income people, children, pregnant women, elderly adults and people with disabilities. It’s run by states but jointly paid for by state and federal governments.

The extra Medicaid money coming to states will be phased out this year.

Traditionally, a Medicaid recipient needs to show they still qualify for the benefit once a year. Because the annual review process didn’t take place, South Carolina’s Medicaid rolls grew by 300,000 above the 1 million South Carolinians typically on Medicaid before the pandemic.

“During the public health emergency, the federal government made the rule that states’ Medicaid agencies should not perform eligibility determinations. So we did not know if they were eligible,” said Robert Kerr, director of the S.C. Department of Health and Human Services. “If they came on the rolls during the pandemic, they stayed on the rolls.”

As part of a federal spending bill passed in December, states must now restart annual reviews of people on Medicaid.

That work will begin in April.

“We’re getting back to the almost the exact same way (it was done) before the public health emergency,” said Jeff Leieritz, the director of communications for the Department of Health and Human Services.

When people no longer qualify for Medicaid, they are directed to the health insurance marketplace created through the Affordable Care Act or encouraged to sign on to their employer’s health insurance plan, Leieritz said.

“Since we have not performed reviews last few years during COVID, we expect some people will drop off those rolls having their eligibility probably change,” Kerr said.

Despite the anticipated drop in Medicaid recipients in the state, Health and Human Services is asking for more money from state coffers to run its health insurance programs.

The agency is asking for nearly $196 million for Medicaid and Medicare programs. Part of that request includes replacing matching dollars lost from a decrease in federal funding because the state’s economy is doing well, Medicare premium increases, increased reimbursement rates, increased costs for inflation and other costs to maintain the same level of service in the state.

“For example, the increased cost of drugs is also in here. We have inflationary costs for drugs we can’t control where we’ve had to increase rates during the year,” Kerr said.