More than 47,000 Illinois residents lose Medicaid as state begins asking recipients to prove eligibility

Updated
Chicago Tribune/TNS

More than 47,000 Illinois residents lost Medicaid health insurance coverage this month — joining millions of people across the country losing Medicaid as states ask recipients to prove they’re still eligible for the program, for the first time since the COVID-19 pandemic started.

In all, 47,625 Illinois residents lost coverage as of Aug. 1, said Jamie Munks, spokeswoman for the Illinois Department of Healthcare and Family Services, in an email.

More Illinois residents are expected to lose coverage in coming months. The people who lost it this month were only among the first group asked to prove they still qualified for Medicaid. The state plans to send letters to new groups of Medicaid recipients each month, asking them to prove their eligibility.

The federal government has estimated that about 700,000 people in Illinois may lose Medicaid coverage by the time the process is complete. The Illinois Department of Healthcare and Family Services is more optimistic, estimating that about 384,000 residents may lose coverage.

Medicaid is a state and federally funded health insurance program for people with low incomes and disabilities that covered about 3.9 million people in Illinois before this first round of redeterminations.

Of the Illinois residents who lost coverage this month, 13,375 individuals were no longer eligible. Another 34,250 lost Medicaid because they didn’t respond to requests to prove their eligibility or because they didn’t provide the state with all the required information, Munks said.

Another 139,538 people were found to still qualify for Medicaid, and will continue to have Medicaid coverage. The state is still determining whether an additional 13,830 people should stay on Medicaid.

Those who are no longer eligible for Medicaid coverage will be given information about finding other coverage, Munks said. For those who lost Medicaid because they didn’t respond to requests for information, the state can reinstate their Medicaid coverage if it receives the required information within 90 days, she said.

People who lost Medicaid may be able to get insurance through their employers or the Affordable Care Act marketplace, though others may end up without coverage, if they don’t take action.

It’s no surprise that many people lost Medicaid during this first round of redeterminations, after three years of not having to prove eligibility, said Stephanie Altman, director of health care justice at the Shriver Center on Poverty Law in Chicago.

“But it still pains me to hear that so many people are going to lose coverage with many of them (losing it) because of bureaucratic reasons,” Altman said. The Shriver Center has been working with the state and others to spread the word about Medicaid redeterminations and to ease the process.

Now, she worries that people who lost Medicaid because of bureaucratic reasons — even though they’re still eligible — won’t be able to get the care they need. They might not be able to get medications or may have to postpone doctor visits, she said.

“We just hope we can get the people who are eligible reinstated as soon as possible and everyone else onto another form of coverage as soon as possible,” she said.

People who lost Medicaid and have no other insurance can still get emergency care at hospitals, because federal law requires hospitals to provide emergency treatment to patients, regardless of ability to pay. If the patient is still eligible for Medicaid, hospital staff will likely help sign that patient up so their care will be covered. If not, the person may get billed, or the hospital may have to absorb the cost.

The overall situation is a result of several pandemic-related changes to federal law. Before COVID-19, Illinois residents on Medicaid had to renew their coverage each year, often by filling out paperwork proving they were still eligible for the program.

When the pandemic began, the federal government began giving states extra money to suspend that requirement. People on Medicaid no longer had to periodically prove they still qualified for the program in order to stay on it.

As the pandemic faded last year, federal lawmakers decided continuous enrollment in Medicaid was no longer needed, and they passed a new bill ending that provision on March 31 of this year.

Nationally, at least 3.8 million people had lost Medicaid as of Aug. 1, according to the Kaiser Family Foundation. About 32% of people who were up for Medicaid renewals across 18 states in April lost coverage, according to the federal Centers for Medicare and Medicaid Services.

There’s wide variation in how many people are losing coverage in each state. In Illinois, about 24% of people up for renewals, so far, have lost coverage. In Texas, 82% of people up for Medicaid redeterminations have been disenrolled, while in Wyoming that figure is at 8%, according to Kaiser. Some states began the process earlier than Illinois.

The federal government has stepped in and paused redeterminations in some states where problems have been identified.

It’s hard to draw conclusions about Illinois Medicaid redeterminations from just this first round, said Samantha Olds Frey, CEO of the Illinois Association of Medicaid Health Plans. But she’s hopeful Medicaid insurance plans and the state will learn more moving forward.

“Obviously, anyone losing coverage is not the desired outcome, but what we’ve seen is in other states, it’s worse than (here), so we are getting some things right here,” she said.

Now, it’s important to find out how to better reach the people losing coverage for bureaucratic reasons, in hopes of reducing that number.

“The ideal is no one loses coverage because of paperwork, but that’s probably not realistic, so how can we continue to work and improve and close that gap?” Olds Frey said.

In recent months, the state, Medicaid managed care plans, health care providers and other groups have tried to alert people about Medicaid redeterminations through social media, television commercials, radio ads, text messages, emails and other communications. Medicaid managed care plans will get lists of the people who lost Medicaid because they didn’t respond to requests for information, so they can continue reaching out to those people in hopes of reinstating them, Olds Frey said.

The Department of Healthcare and Family Services recommends that people up for Medicaid renewals set up online accounts at abe.illinois.gov, verify that their current addresses are on file, and look up their due dates so they know when to expect redetermination materials. People can also call 855-828-4995 to find out their renewal dates, as long as they have their recipient identification number or nine-digit medical card number.

Some Illinois residents will have their Medicaid coverage automatically renewed, without the need to take any action, if the state already has enough of their information.

lschencker@chicagotribune.com

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