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Md. health dept. processed 1.5 million Medicaid enrollees in 12 months; one month left in ‘unwinding’


Md. health dept. processed 1.5 million Medicaid enrollees in 12 months; one month left in ‘unwinding’

Apr 19, 2024 | 6:37 am ET
By Danielle J. Brown
Md. health dept. processed 1.5 million Medicaid enrollees in 12 months; one month left in ‘unwinding’
Maryland Department of Health has evaluated 1.5 million people on Medicaid for redetermination since March 2023. Photo by Danielle E. Gaines.

In March 2023, the Maryland Department of Health began sifting through almost 1.8 million Medicaid enrollees to see who still qualifies for the federal health care plan for low-income households.

A year later, the department has processed over 1.5 million Medicaid enrollees, and has determined that most people still qualified, while hundreds of thousands of others were no longer eligible.

Prior to the pandemic people with Medicaid insurance had to reapply annually. Medicaid terminations were paused over the COVID pandemic in order to ensure people were covered during a global health crisis.

But starting in 2023, Medicaid re-enrollments were no longer automatic, and people had to reenroll in the program to continue coverage in a period often referred to as the ‘Medicaid unwind.’

Since then, well over 300,000 people have lost Medicaid coverage, according to monthly-data updates from the Department of Health. And there is still one month left in the Medicaid unwinding period for Maryland.

>> TALK TO US: Maryland Matters wants to hear from people affected by changes in their health care coverage during the Medicaid unwinding process. If you would like to share your story, click here.

This week, the department released data updated with the March redetermination information.

At the start of the unwinding period, the data show that there were about 1,787,000 people enrolled in Medicaid in March 2023. A year later, there are 1,690,000 people covered by the program.

Reasons for terminations vary. Some people who were eligible for Medicaid at the start of the COVID pandemic now earn too much money to qualify for the low-income focused program. Others may no longer receive Medicaid coverage because they aged into Medicare, the federal health care plan for retirees.

But most of the terminations are due to what are called “procedural terminations,” which means that someone either did not start or did not complete their Medicaid reapplication.

Those who are disenrolled due to “procedural” reasons might still qualify for Medicaid, but without completing a reapplication to the program, state officials cannot verify eligibility and will terminate coverage for that individual.

Since March 2023, between 59% to 88% of each month’s terminations were due to procedural reasons, and not necessarily because the individual no longer qualified for the program.

People with procedural terminations have short window after losing coverage when they can reapply to Medicaid and get covered again if they are still eligible.

To tackle the immense number of Medicaid recipients, the state health department decided to break up the initial 1.8 million enrollees into 12 monthly cohorts. Each cohort of Medicaid redeterminations have a two-month timeframe to complete the reapplication process once they are notified about their status by the Maryland Department of Health.

There were 101,765 people on Medicaid due for redetermination in the March cohort. That means that in February, they received a notice in the mail or online from the department to reapply for Medicaid insurance and were warned that they had a Mar. 31 coverage end date, according to the department.

Of those enrollees, 73,350 maintained health care coverage under Medicaid, but 22,220 people were disenrolled. Another 6,195 enrollees were pending review at the time the report was released.

Of the 22,220 who were disenrolled from Medicaid at the end of March, only 4,672 lost coverage because they longer qualified for the program, due to age-related reasons or income.

There were 17,548 people disenrolled due to procedural terminations, meaning they not finish or did not start the reapplication process during their two month window.

In the year since Medicaid terminations resumed in Maryland, there have been hurdles in the process of evaluating the eligibility of 1.8 million Medicaid recipeints.

That includes reinstating coverage for thousands of children after improper terminations, backed up phone-lines that stalled customer service help, and a national 3-month pause on procedural terminations after federal officials noticed that many states were improperly terminating Medicaid for people who still qualified.

According to the department’s schedule, there will be one last round of Medicaid disenrollments for those whose coverage ends in April. Those people were notified in February of their need to reapply. Updated data is expected be published in May.