State and local officials are warning that anyone enrolled in Medicaid and Child Health Plan Plus programs needs to watch their mailboxes because eligibility redeterminations have begun for the first time in three years.
The wind down of pandemic-era protections for those enrolled in the nation’s health care system for low-income individuals will rival the enactment of the Affordable Care Act in impact, although it will adversely affect the number of uninsured Americans.
The move will demand action from nearly one third of La Plata County residents – 16,432 people – who are enrolled in the Medicaid. In Archuleta County, 11,943 people, or 43% of residents, will need to submit paperwork to determine their eligibility; nearly 34% of Montezuma County residents are enrolled in Medicaid.
Since the COVID-19 pandemic began in March 2020, Colorado’s Medicaid program, Health First Colorado, has been under a federally mandated continuous coverage requirement. Although the Colorado Department Health Care Policy and Financing has continued to conduct some eligibility determinations, nobody enrolled in the program has lost coverage or been found ineligible.
As a result, Medicaid enrollment in La Plata County grew 46% between March 2020 and December 2022.
But the Consolidated Appropriations Act signed into law on Dec. 29 began to chip away at pandemic-era supports to social safety nets. The law ended the flow of federal dollars to Supplemental Nutritional Assistance Programs, slashing emergency allotments, and removed the continuous coverage requirement for state Medicaid programs.
The state is estimating that 19% of those enrolled in the program could be deemed ineligible statewide.
Although the exact percentage of people who will be unenrolled could vary regionally depending on where income has grown most, about 3,122 people can expect to lose coverage in La Plata County. In Montezuma County, about 2,269 people will lose coverage along with 891 people in Archuleta County.
“Every person that is being redetermined for their benefits, we’re looking at that as potentially losing their health insurance,” said Kalisha Crossland, the community health director at San Juan Basin Public Health.
State and county officials are urging those enrolled in Medicare to go to CO.gov/PEAK, make an account, and ensure that their address and email information is correct.
“What we are hearing from people in our community who are currently on Medicaid is a lot of anxiety about if they lose their health care coverage,” said Martha Johnson, director of Human Services for La Plata County.
Everyone currently enrolled in Medicaid will have their eligibility reevaluated on the anniversary of their enrollment. Recipients will receive a packet in the mail requesting detailed information about their family’s income status. Failure to sign and submit those materials will result in unenrollement.
In anticipation of several thousand residents of Southwest Colorado losing their Medicaid coverage, health care advocates are rallying to ensure that nobody has a coverage gap, exposing them to potentially costly medical bills.
“Medical bankruptcies are the most common form of bankruptcies that we see in the state,” said Marc Williams, spokesman for Colorado Department Health Care Policy and Financing. “We’re really trying to encourage folks to be thinking and planning ahead so as to avoid that (gap).”
Anyone who is determined to be no longer eligible can seek out alternatives such as employer-sponsored health care, veterans benefits or family members’ insurance.
Emma Tomlinson, lead of SJBPH’s health care literacy program, said the department has resources available to help those who are no longer eligible for Medicaid. She and the program’s staff members can help those who need insurance navigate the complexities of the private insurance landscape.
Coloradans can also turn to Connect for Health Colorado, the state’s health care marketplace. Losing Medicaid coverage meets the definition of a “qualifying event,” allowing someone to enroll in health care coverage outside of the open enrollment period.
Tomlinson said the state also has many tax credits and cost-sharing reductions through which customers can reduce the price of insurance.
Still, she said, the change can be abrupt for those who have grown accustomed to Medicaid for the last three years or longer.
“Coming from not paying any monthly premiums, not being expected to meet a deductible or out-of-pocket maximum – this is a huge education piece,” Tomlinson said.
The first round of eligibility paperwork was sent out mid-March. The process will occur over the next 11 months as the eligibility of all Medicaid participants is examined.
rschafir@durangoherald.com
