Ensuring Medicaid Eligibility as States Resume Redetermination Process

Business

04/05/2023

nurse listening to pregnant patient's heartbeat

At the beginning of the COVID-19 pandemic, the federal government provided states with additional federal funding in exchange for keeping individuals covered under Medicaid during the public health emergency (PHE). As a result, enrollment in Medicaid surged 30% to more than 90 million people, according to the Kaiser Family Foundation.

Now, due to changes passed by Congress under the Consolidated Appropriations Act of 2023, states may resume the process of redetermining individuals’ Medicaid eligibility beginning as early as April 1, 2023. With this change, millions of people who are currently enrolled in Medicaid, who did not have to renew coverage during the pandemic, are now at risk of losing health coverage and must take proactive steps to ensure their eligibility.

Many states have not gone through the redetermination process in almost three years, and the volume of redeterminations is unprecedented, with 1 in 4 individuals potentially affected. In fact, it is estimated 18 million people could lose access to Medicaid coverage as a result of redetermination.

Many Medicaid beneficiaries are unaware of these changes. According to the Urban Institute, 62% of adults enrolled in, or who have a family member enrolled in Medicaid, have reported hearing nothing at all about the forthcoming eligibility redeterminations. Meanwhile, one-third have reported only hearing some or little about the resumption of renewals.

Centene believes every individual deserves access to affordable health coverage that protects their health and financial stability. As a result, we are working to help ensure individuals remain eligible for Medicaid coverage or find other appropriate coverage that is best for themselves and their families.

Our teams have been preparing for more than a year to ensure members and providers have the information and resources they need to navigate the redetermination process. We have been proactively communicating with Medicaid members and providers, our call centers are addressing member questions, and our health plans have been working at the local level to ensure necessary support is available.

As states initiate the redetermination process, Medicaid beneficiaries are encouraged to keep their contact information up to date to receive communication from their state Medicaid agency. It is important to promptly follow up on any notices or required next steps.

If you or your family currently received Medicaid benefits and are uncertain of your eligibility, contact your state Medicaid agency for more information.