Medicaid Unwinding Update
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Medicaid Unwinding Update
Here is one of the effects of not having universal healthcare.
Medicaid is a joint federal and state program that, together with the Children’s Health Insurance Program (CHIP), provides health coverage to many Americans, including children, pregnant women, parents, seniors, and individuals with disabilities. Medicaid is the single largest source of health coverage in the United States. During the pandemic it covered about 94 million of us.
To participate in Medicaid, federal law requires states to cover certain groups of individuals. Low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI) are examples of mandatory eligibility groups. States have additional options for coverage and may choose to cover other groups, such as individuals receiving home and community-based services and children in foster care who are not otherwise eligible.
The Affordable Care Act of 2010 created the opportunity for states to expand Medicaid to cover nearly all low-income Americans under age 65. Eligibility for children was extended to at least 133% of the federal poverty level (FPL) in every state (most states cover children to higher income levels), and states were given the option to extend eligibility to adults with income at or below 133% of the FPL. Most states have chosen to expand coverage to adults, and those that have not yet expanded may choose to do so at any time.
When the pandemic hit Medicaid was expanded to make sure more people could be covered and to save lives and to slow the spread of the virus, because in a public health emergency the more people who can get medical care, the better it is for the population as a whole. Those on Medicaid did not have to re-enroll each year.
This past Spring the COVID 19 pandemic was declared over and so it was time to return to the pre-pandemic rules for eligibility for Medicaid and CHIP.
The Kaiser Family Foundation has been tracking the unwinding and here is how it is going.
At the height of the pandemic there were 94 million of us using Medicaid. That’s about 30% of us. So far, states have reviewed the applications for 28 million that reapplied. so there is about 71% left to go. Of the 28 million reviewed more than 7.3 million have been denied coverage (about 25%). Of those 7.3 million removed, more than 5.1 million were removed for procedural errors such as not responding to requests for information to verify their eligibility. It’s unclear how many are actually still eligible. Nationwide, states have already disenrolled at least 1.8 million children in the 20 states that provide the data by age.
State and local Medicaid officials say they have tried contacting enrollees in multiple ways — including through letters, phone calls, emails, and texts — to check their eligibility. Yet some Medicaid recipients lack consistent addresses or internet service, do not speak English, or are juggling more pressing needs.
Denying coverage wrongly for these patients puts them in a horrible bind. If they become ill, medical care is unaffordable. Chronic illnesses and required medication are ignored in favor of things like food and shelter.
Here is a graphic so you can see how many are successfully re-enrolled and how many were removed by state (not all states represented - just the ones with the largest Medicaid populations). (Credit to the Kaiser Family Foundation)
Some of the people legitimately removed make too much money now. One mentioned in the KFF story was a single mom who now makes $22/hour. Happily, her 2 children have CHIP, but the reduced ACA cost for her is $260/month. Assuming she pays Medicare and Social Security and NO income taxes her health insurance cost is 8% just for her. It’s no wonder she can’t afford it. Here is a link to the KFF story.
Of course, with Universal Healthcare we wouldn’t have this discussion. I’m just saying.
ACTION
Let’s let our representatives know about this tragic situation unfolding, because they can do something about it. They can pass Universal Healthcare legislation to cover all of us, cradle to grave, increase the availability of providers in medical deserts, and do it for far less than we, as a country, spend now. You can find your Member of Congress and Senators contact info in the Resources section below.
You can send them an email with this RESISTBOT message by texting SIGN PKAGSJ to 50409.
“ I am your constituent and I want you to know that states are dropping people from Medicaid for procedural reasons, incomplete forms, address errors, language issues, and not because they make too much money. This is the unwinding of Medicaid post pandemic. About 28% of the 94 million Medicaid participants have been reviewed and about 5.1 million have been dropped for these errors. Many of these people have no way to afford an ACA plan even with the discounts given. I’d like to also point out that of those losing coverage about 1.8 million were children.
There is nothing good about any of this except that you can fix it by enacting Universal Healthcare. I recommend HR 3421, the Improved Medicare for All Act. It cover all of us, cradle to grave, increases the availability of providers in medical deserts, and will do it for far less than we as a country spend now.
I know saving democracy takes a lot of energy. But we need to be able to be healthy enough to enjoy that democracy. I strongly urge you to enact Universal Healthcare now and stop this madness. Thank you.”
Lung Cancer Screenings
Stat: Lung Cancer Screening Guidelines Updated For Cigarette Smokers
Most lung cancer screening guidelines hinge on how much people smoked tobacco and when they last smoked, but the American Cancer Society now says it doesn’t matter how long ago they quit. On Wednesday, the ACS released guidance recommending that anyone with a significant smoking history get an annual low-dose CT scan for lung cancer.
I was a heavy smoker for a long time. Let’s see if insurers decide to cover this one. Watch this space.
Reproductive Rights
Abortion is essentially banned in about 1/2 the United States. Those states treat women as second class citizens incapable of being in control of their own healthcare decisions. Some have made it illegal to facilitate someone getting an abortion out of state, like giving them a ride. This is police state activity by people who behave just like the Taliban.
Anyway, there are four pieces of legislation that can change this. They are:
1. The Women’s Health Protection Act to codify Roe v. Wade.
2. The Ensuring Women’s Right to Reproductive Freedom Act to affirm the right to travel to receive legal abortion care, protecting patients, providers, and anyone else who helps someone travel for care.
3. The My Body, My Data act would protect personal reproductive data by creating a national standard for what data can be collected, saved or shared.
4. The Abortion Justice Act does that by addressing the systemic barriers and systemic racism in reproductive health care to ensure that everyone, everywhere can actually access care.
Here is a link to a letter to the editor I wrote asking that my member of Congress support those bills.
EXTRA CREDIT
Send a letter to the editor to newspapers in your area asking that your Congressperson support those four bills. You can copy my letter and edit appropriately.
RESOURCES
Healthcare Advocacy (Us)
Website
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
By phone: (202) 224-3121
By email: democracy.io
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
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
Disinformation Management
Cybersecurity Infrastructure Security Agency
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
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