I don’t envy state Medicaid workers at the moment. They are in the midst of what one expert has called one of the greatest challenges to the program in its history.
That challenge, of course, is the unwinding, a process of reassessing and verifying the eligibility of every individual on Medicaid rolls. Not an easy task.
The result of the unwinding, which started in April, is millions of recipients, young and old, have lost coverage nationwide. What is to blame? Overwhelmingly, it’s procedural disenrollments, terminations related to people who have failed to submit appropriate paperwork and documentation. So thorny is this problem that as of last week, 14 states paused their Medicaid terminations to work on issues related to renewal requirements, according to a report by InsideHealthPolicy.
Two of the groups negatively affected by this predicament are, not surprisingly, older adults and people with disabilities. Damon Terzaghi, director of Medicaid home- and community-based services for the National Association for Home Care & Hospice, has been tracking this, and the numbers are concerning. As of this week, he told me in a podcast, about 140,000 older adults and people with disabilities in 23 states have lost coverage since April. That equates to about 6.2% of total disenrollees in those states. The numbers are sure to swell.
These two groups most likely have suffered a disproportionate impact from procedural problems because of their complex eligibility criteria, he believes.
What is the consequence of these groups losing coverage? Not being able to access healthcare, such as needed prescriptions, for example, and the possible loss of their home care services, which could affect their overall health.
Terzaghi is analyzing the terminations on a daily basis to alert states that they need to provide data on these groups and not lump them into the broader Medicaid statistics. Home care providers, for their part, can make sure their patients are aware of the redetermination processes underway, know where to provide updated information, and make sure that all requested documentation is returned in a timely manner, according to NAHC.
Even as the pandemic’s grip lessens, it’s evident we need an all-hands-on-deck approach to restore normalcy in an otherwise chaotic and unsettling situation.
Liza Berger is editor of McKnight’s Home Care. Email her at [email protected].