REGION — Are you a New York resident on Medicaid? Make sure your information is current, because the unwinding is about to begin.

It’s something PA residents know well—because for them, the process started back in May.

The Kaiser Family Foundation (KFF), a nonprofit that focuses on health care issues, found that at least 1.349 million Medicaid enrollees have lost their coverage as of June 20.

Why were so many people on Medicaid? Why are they losing coverage?

Before the pandemic, individuals had to renew their Medicaid coverage every year. That requirement included updating their contact information and their income. During the initial phase of the COVID-19 pandemic, Congress passed the Families First Coronavirus Response Act, which temporarily suspended the annual reenrollment to ensure that people maintained their health care coverage. As a result, people who received Medicaid were able to remain continuously covered without going through the recertification process. 

On March 31 of this year, the provision came to an end.

Medicaid and the Children’s Health Insurance Program, aka CHIP, grew by 23.3 million to nearly 95 million from February 2020 to the end of March 2023, the KFF found.

And now, because of the end of continuous coverage, it is estimated by the KFF that up to 17 million people across the country are at risk of losing their Medicaid coverage. That’s due to reasons ranging from failure to complete renewal applications to making too much money to qualify for Medicaid. 

New York will officially begin unwinding people from Medicaid in July.

What’s New York doing about it?

In order to understand the impact of Medicaid unwinding on local community members, the River Reporter conducted interviews with Michelle Bridges, head social welfare examiner at the Sullivan County Department of Social Services, and Giselle Steketee, deputy commissioner of social services. 

Through their experience with the Medicaid program, Bridges and Steketee said that New York State “has implemented several procedures for recertification” to ensure that individuals do not lose their coverage. 

When it comes to a change in address or not finishing the paperwork—major reasons that people have lost Medicaid nationwide—Bridges stressed that precautions have been put in place so that the state “can’t just go in and close [accounts]” without the county or state attempting to actively seek an updated address, or send out another recertification notice. 

They also noted that there are different entities involved in handling participant’s coverage, based on certain criteria. 

The local department of social services handles individuals who are 65 years or older, who have a disability, who are on Medicare or who have no children under 21. 

Anyone falling into any of these categories can go directly to the local Department of Social Services. See “Get in touch” sidebar in the box at left below.

Those who longer qualify for Medicaid would go to the Marketplace instead.  

That’s the state health insurance marketplace, aka the NY State of Health, the Health Exchange or the Marketplace. For more information visit nystateofhealth.ny.gov.

Confused? There are certified application counselors (aka navigators), who help people access Medicaid and insurance through the New York State of Health, said Dan Hust, Sullivan County director of communications. Learn more at the NY State of Health website above.

Why might New Yorkers lose health care? 

Bridges and Steketee pointed out that most cases stem from individuals failing to complete the Medicaid renewal process. (Nationwide, 71 percent lost coverage for “procedural” reasons, not due to being ineligible, according to the KFF.) 

In line with that, Bridges and Steketee noted that so far they are “not seeing too many people who have lost their [Medicaid] due to excess income” gained post-pandemic. 

They credit this to the state’s new budget agreement, reached between the legislature and the governor, which expanded coverage for people who are age 65 and over, or are blind or disabled. Under this agreement, the  guidelines for Medicaid coverage increased to 138 percent of the federal poverty level; the income level for a single person went from $934/month to $1,677 a month.

For a married couple, it increased from $1,367 a month to $2,268 a month.  

So what else drives the problem? 

Bridges and Steketee said that the main reason people could be at risk in Sullivan for losing Medicaid is due to a “disconnect with communication” in terms of correspondence and receiving necessary paperwork. 

All residents on Medicaid should have been receiving some sort of correspondence in the mail, they said. Anyone who has not received a letter should call the Sullivan County Department of Social Services; see “Get in touch,” in the box at left below. 

The department is ready to assist “in any way we can,” Bridges and Steketee said. It can address any inquiries or difficulties recipients might have. The goal is to ensure that contact information is accurate and to prevent any complications during the renewal process. 

In Pennsylvania, where the process has begun

Across the border, in Wayne County, PA, Rebecca Mead and Kyle Davis report that not as many people lost coverage as they anticipated.  

They are enrollment coordinators for the Outreach and Enrollment Center in Honesdale, PA. The center is part of Wayne Memorial Community Health Centers (WMCHC), a comprehensive health care group with a service area that includes Wayne, Pike, Susquehanna and Lackawanna counties. The WMCHC is a federally qualified health center, which means it is subsidized by the federal government to provide certain services, particularly to the under- and uninsured. 

Mead and Davis said that WMCHC “can actively help people enroll in and assist with” Medicaid, Pennie (the state health insurance marketplace) and food programs. 

All of WMCHC’s medical offices also offer a sliding-fee scale for services rendered for those who qualify. 

Mead and Davis said data is still coming out, but according to the Pennsylvania Department of Human Services, as of May in Wayne County, only 19 individuals lost their Medicaid coverage because of changes in their income, and only an additional three were terminated because of a failure to return documents.  

Statewide, 4,357 lost coverage due to income requirements and 3,551 did not send in their renewal documents.

Both enrollment coordinators said they utilized the local media heavily, through public service announcements, to help get out the word about the end of the continuous coverage benefit. 

To find insurance through Pennie, visit the Outreach and Enrollment office. See “Get in touch.” 

“Our biggest concern is for people who are finding themselves without medical coverage when they most need it,” said Davis. 

For those who purchase insurance on Pennie, depending on income levels, individuals could be eligible for tax credits on certain health-related costs. 

When asked for a final message to readers, both Mead and Davis emphasized how important it was for anyone seeking Medicaid coverage to “keep their contact information up to date” to avoid any issues with renewals. They stressed that their office can help.