Dropping Patients from Medicaid
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Happy Friday Healthcare Advocates
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Note the resource section below has been updated with abortion related info. Where to find a provider, how to get pills, how to secure your communications so it is less likely the police will come knocking etc. If we had the Women’s Health Protection Act passed in Congress I could delete those references.
Medicaid Problems
A brief refresher. Medicaid is a joint federal and state program to provide healthcare to the poor. The federal government provides most of the funds to operate Medicaid programs to the states. Each state gets to decide how to provide the care, and what is covered. Not all procedures and medications are available in all states. Many states use a managed care type of approach (like an HMO).
Generally, you have to be at the federal poverty level to be eligible. For 1 person it is an yearly income of $14,580, for a family of 4 it is $30,000. It covers about 80 million Americans. That's about 24% of the US population. Medicaid was expanded twice. Once under the ACA to allow coverage for those whose income was up to 138% of the federal poverty limit. Not all states chose to do that. And once during the pandemic. During the pandemic you did not have to complete the annual application for Medicaid.
Since the Pandemic is “over” everyone has to reapply for Medicaid and some states have been busy denying coverage to people often for minor errors in the application.
According to the Kaiser Family foundation At least 3,196,000 Medicaid enrollees have been disenrolled as of July 20, 2023, based on the most current data from 33 states and the District of Columbia. The number is really higher because 17 states are silent so far. Overall, 39% of people with a completed renewal form were disenrolled in reporting states. Of all the disenrolled 31% were children. Heartwarming isn’t it.
74% of the people denied Medicaid were for procedural errors in the applications. That’s almost 3 million people who lost Medicaid coverage inappropriately. Think of typos and the like. Not a good reason to lose insurance.
You can see that there are certain states that just want to deny medical coverage to the poor New Mexico, Florida, Texas, etc.
According to Modern Healthcare, CMS has already ordered several states to pause redeterminations to address their failure to adhere to federal standards and is working with about a half dozen states to correct ongoing violations. The agency has required some states to pause so-called procedural terminations not related to eligibility and to reinstate coverage for those affected by policy, operational or compliance violations. CMS is monitoring an additional dozen states to determine if they are in violation of Medicaid regulations. One state failed to provide some enrollees with renewal forms, and another didn’t implement required auto-renewal mitigation strategies, according to a CMS fact sheet. The agency continues to monitor states, intervene when necessary and offer technical assistance.
This is a sorry situation where so many states are choosing to deny needed medical coverage to the poor. I’m glad that the federal government is watching them closely.
It seems that whenever the states are responsible for action we the people get the short end of the stick. Voting rights, reproductive healthcare, and now Medicaid and CHIP. I’m sure they are proud of denying coverage to children even for procedural errors.
Anyway, I’m glad that the Center for Medicare and Medicaid services is on top of it. Let’s encourage CMS to keep a watchful eye on the states.
ACTION
Chiquita Brooks-LaSure is the Administrator for the Centers for Medicare and Medicaid Services. Here's her email Chiquita.Brooks-LaSure@cms.hhs.gov.
Subject: Keep a Watchful eye on States Disenrolling Medicaid Patients.
Ms. Brooks-LaSure,
Thank you for keeping a watchful eye on the disenrollment of Medicaid patients. I’m glad that you have paused the disenrollment in states that eager to dump patients out of the system and forced the states to reenroll so many of them. So many children’s healthcare relies on you making the states tow the line. Keep up the good work.
PS If we had Universal Healthcare we could have a completely different conversation.
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
https://www.commoncause.org/find-your-representative/addr/
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Plan
Reproductive Health
NARAL - Pro Choice America
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water Resistbot write up