Milken Researchers Find Drops in Healthcare Coverage After Medicaid Disenrollment – ​​The GW Hatchet

Researchers at the Milken Institute School of Public Health found a significant decline in health care coverage at health centers serving low-income communities after last year’s mass disenrollment from Medicaid in a study published earlier this month.

Researchers sent surveys to more than 1,000 community health centers, which provide affordable health care to low-income areas, and found that 95 percent of health centers saw patients disenrolled from Medicaid after continued enrollment in the era of the COVID-19 pandemic — causing the pandemic was discontinued Eligibility checks from the era – ended in March 2023. Peter Shin, associate professor of public health and lead investigator of the study, said the disenrollment causes vulnerable populations such as low-income patients and communities of color to lose health care coverage and delay medical treatments because they fear they won’t are. can afford.

Medicaid provides health care coverage to low-income people and people with disabilities, allowing community health centers to receive reimbursement for treatment because the centers provide lower-cost care to uninsured patients. If patients do not have insurance that can fully reimburse the centers, the centers lose revenue.

During the pandemic, Congress has halted Medicaid “churn,” or eligibility inspections, based on income changes that could cause patients to lose coverage, requiring Medicaid programs to keep patients enrolled throughout the pandemic. After the pause expired, and as a result, state Medicaid agencies notified people they no longer had coverage who were struggling to fill out the paperwork.

“The biggest finding was that every health center, no surprise, reported that they were seeing a decreasing impact on their patients,” Shin said. “The biggest one was that it was estimated that about one in four patients will lose coverage.”

The Geiger Gibson Program in Community Health, a program of Milken’s Department of Health Policy and Management, partnered with the National Association of Community Health Centers to survey community health center CEOs about the number of patients disenrolled from Medicaid and their demographics .

Shin said the study found that of the 95 percent of community health centers that reported disenrollment, nearly one in four patients disenrolled. He said researchers believed these centers would be most affected by the phaseout because many of their patients rely on Medicaid and the centers primarily serve low-income communities and communities of color.

“We want to be able to map out what the impact would be for this group of very vulnerable or high-risk people or for population groups at high risk of poor health problems,” Shin said.

The study found that 74 percent of patients who had unenrolled had not re-enrolled. Shin said people had difficulty re-enrolling and proving their eligibility because of the amount of paperwork.

To re-enroll in Medicaid, a patient must update their contact information with the state’s Medicaid office, check their mail for information about eligibility, and, if eligible, complete a renewal form mailed to them will receive. The process and eligibility requirements vary by state.

“Half or more than half reported seeing a major disruption in patient care; some patients simply could not return or continue their treatment,” Shin said. “A lot of the things that we did expect, we’re just blown away by how serious it was, in terms of the reporting.”

The 2010 Affordable Care Act required states to expand Medicaid eligibility so more people could get coverage by adjusting the income limit. The Supreme Court ruled in 2012 that states cannot be forced to comply. As a result, 40 states and DC have expanded Medicaid, while 10 have not.

Shin said the study found that more people had disenrolled in Medicaid expansion states than in states where Medicaid had not expanded. The study found that in the non-expansion states, 40 percent of those disenrolled were children.

“They’re delaying their care,” Shin said. ‘They postpone their treatment. They don’t come for routine visits. So it will clearly have serious consequences for their health in the future.”

Rebekah Morris, a public health graduate student and research associate on the study, said Medicaid disenrollment threatens the operations of community health centers because of the loss of revenue associated with the increase in uninsured patients, as the centers treat patients regardless of their ability to pay.

Morris said the disproportionate loss of coverage among vulnerable populations such as children, the disabled and the elderly means it is likely to be particularly difficult for them to navigate the re-enrollment process and complete the necessary paperwork. She said more communication is needed between community health centers and Medicaid agencies to help patients re-enroll.

“We really want to make sure there’s a lot of integration where health centers and local Medicaid agencies are talking,” Morris said. “That we learn more about the issues that patients are having with re-enrolling in Medicaid and the confusion and try to address some of those gaps and hopefully we can eliminate this in future best practices.”

Healthcare experts say states should simplify the re-enrollment process and expand reach to people who have lost coverage but are still eligible for Medicaid by providing re-enrollment information on social media.

Diane Rowland, executive vice president emeritus of the Kaiser Family Foundation, a nonprofit health policy research organization, said states should streamline the re-enrollment process by designating places where people can re-enroll or by establishing enrollment days held in health centers.

“Can you have the redeterminations done at a community health center?” said Rowland. “Can you have social workers to help with that? Some states have been very effective in their outreach efforts and really have enrollment days and a lot of outreach, and other states just let people fall through the cracks.

Rachel Swindle, a researcher at the Center on Health Insurance Reforms at Georgetown University, says states should realize that young people, who often don’t check their email or answer their phones, would benefit more from social media for learning how to recover their email. to enrol.

“Trying to meet people where they are and sending text messages, for example,” Swindle said. “Everyone in our generation, Gen Z, millennials, we don’t answer the phone. We don’t necessarily check our email that often, so we send text messages or place ads on Instagram or TikTok.”