About 15 million US citizens could lose Medicaid coverage: 7 things to know

by Aditya Kumar

The expiration of the pandemic-era ban on Medicaid coverage has left approximately 15 million Americans at risk of losing their healthcare benefits. This move has sparked uncertainty and concern among families who rely on Medicaid for their healthcare needs. The unwinding process, as it is being called in the Medicaid world, involves states resuming redeterminations to determine eligibility, which could result in disenrollment for those who no longer meet the requirements due to changes in circumstances, such as income levels.

One of the major concerns surrounding this change is the disproportionate impact it is expected to have on children, Latinos, and Black Americans. These vulnerable communities already face significant challenges in accessing healthcare, and the potential loss of Medicaid coverage only exacerbates the issue. Without adequate healthcare coverage, individuals and families may struggle to afford essential medical services, prescriptions, and treatments.

For individuals and families who find themselves dropped from Medicaid coverage, there are several important steps they can take to navigate the situation:

1. Re-apply for Medicaid: Acting quickly is crucial if you have been disenrolled. Complete a new Medicaid application within the 90-day restoration period after disenrollment. Even if there were procedural issues causing the disenrollment, you may still be eligible.

2. Challenge the State’s Decision: If you cannot reapply within the 90-day period, request a fair hearing from your Medicaid office. States are required to provide a fair hearing, allowing you to challenge the decision. Be sure to follow your state’s specific appeal process.

3. Explore Health Insurance Marketplace: If you are deemed ineligible for Medicaid, explore plans with low or no-cost premiums through the Health Insurance Marketplace on HealthCare.gov. Subsidized coverage options are available, making it affordable for many families.

4. Plan Ahead: If you know that your Medicaid coverage will end, apply for a Marketplace plan as early as 60 days before your Medicaid coverage ends. Benefits will begin at the start of the next calendar month after enrollment.

5. Consider Alternative Options: If Medicaid coverage is not available, explore other options like employer plans, partner’s employer plans, or student health plans. Most plans allow enrollment up to 30 days after losing coverage, regardless of their open enrollment period.

6. Stay Informed: Stay updated with your state’s Medicaid policies and deadlines. Being aware of changes and requirements can help you navigate the system effectively.

7. Seek Assistance: If you find the process overwhelming, there are numerous organizations and resources available to assist you. Reach out to local community centers, healthcare navigators, or non-profit organizations specializing in healthcare access.

It is important for individuals and families to be proactive and take these steps to ensure they have access to the healthcare they need. The potential loss of Medicaid coverage should not stand in the way of receiving essential medical services and treatments. By staying informed, exploring alternative options, and seeking assistance when needed, individuals and families can navigate this challenging situation and ensure their healthcare needs are met.

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