About 15 million US citizens could lose Medicaid coverage: 7 things to know

Expiration of pandemic-era ban has put 15 million Americans at risk of losing Medicaid coverage

The expiration of the pandemic-era ban has put approximately 15 million Americans at risk of losing their Medicaid coverage, creating uncertainty and concern among families. The unwinding process, as it's being called in the Medicaid world, means states are resuming redeterminations, potentially leading to disenrollment for those who no longer meet the requirements due to changes in circumstances, such as income levels. This change is expected to disproportionately affect children, Latinos, and Black Americans, raising concerns about healthcare access for vulnerable communities.

Cindy Clemons, center, receives dental care from Meharry Medical College School of Dentistry third-year student Onyeka Oguagha, left, and oral surgery resident Matthew Moore, right, Tuesday, Sept. 12, 2023, in Nashville, Tenn. Clemons was able to receive treatment after an expansion of the state's Medicaid program. (AP)

Here are 7 important steps individuals and families can take if they find themselves dropped from Medicaid coverage:

1. Re-apply for Medicaid:

If you've been disenrolled, it's crucial to act fast. Complete a new Medicaid application within the 90-day restoration period after disenrollment. Even if there were procedural issues causing the disenrollment, you may still be eligible.

2. Challenge the State's Decision:

If you can't reapply within the 90-day period, request a fair hearing from your Medicaid office. States are required to provide a fair hearing, allowing you to challenge the decision. Be sure to follow your state's specific appeal process.

3. Explore Health Insurance Marketplace:

If deemed ineligible for Medicaid, explore plans with low or no-cost premiums through the Health Insurance Marketplace on HealthCare.gov. Subsidized coverage options are available, making it affordable for many families.

4. Plan Ahead:

If you know your Medicaid coverage will end, apply for a Marketplace plan as early as 60 days before your Medicaid coverage ends. Benefits will begin at the start of the next calendar month after enrollment.

5. Consider Alternative Options:

If Medicaid coverage isn't available, explore other options like employer plans, partner's employer plans, or student health plans. Most plans allow enrollment up to 30 days after losing coverage, regardless of their open enrollment period.

6. Stay Informed:

Stay updated with your state's Medicaid policies and deadlines. Being aware of changes and requirements can help you navigate the system effectively.

7. Seek Assistance:

If you find the process overwhelming, there are numerous organizations and resources available to assist you. Reach out to local community centres, healthcare navigators, or non-profit organizations specializing in healthcare access.