Virginia to review 2 million for Medicaid eligibility Virginia set to review 2 million for ‘safe haven’ Medicaid eligibility

Virginia is about to begin a comprehensive 12-month review of over 2 million people in its Medicaid program for the elderly and disabled and low-income families – it’s just a matter of when.

The federal government program, supercharged by from Virginia extension of eligibility in 2019 under the Affordable Care Actadded more than half a million people since the start of the COVID-19 pandemic, drawing on more than $1 billion additional federal funding to provide health care to people who cannot afford to pay.

“It has been our honor for Medicaid to serve as a safe haven for those covered by Medicaid during the pandemic,” said Karen Kimseydirector of the Department of Medical Assistance Serviceswhich administers the state’s Medicaid program.

But a reckoning is looming as the federal government prepares to end the public health emergency as early as mid-July, forcing states that received emergency assistance during the pandemic to redetermine the eligibility of those registered on their Medicaid lists.

It promises to be a long and laborious process, which could result in up to 20% of Medicaid recipients losing coverage because they are no longer eligible.

“It’s 400,000 people [in Virginia],” mentioned Doug Graygeneral manager of the Virginia Public Health Plan Association, whose managed care companies provide most of the coverage. “That’s a lot of people.”

“The size and importance of this one is quite daunting,” Gray said.

State agencies working with nonprofit health care advocates, medical providers and insurance companies are trying to make the process less daunting for people who rely on Medicaid for medical coverage.

The state has already begun running advertisements on social media and other digital media – in English and Spanish – which will soon be followed by radio and television to inform recipients of the process and ask them to make sure that their contact information is up to date so they can stay well informed.

The campaign also mails information to more than 1.1 million households.

“We want to let people know what’s coming,” Kimsey said.

They’re also trying to avoid confusion and misinformation about what the so-called “rollout” process means for Medicaid recipients, who tend to be among the most vulnerable people in communities across Virginia – and among the most misunderstood.

About 832,000 Medicaid beneficiaries in Virginia are children and about 814,000 are adults of working age. More than 153,000 beneficiaries are disabled or blind and almost 85,000 are over 65 years old. Demographically, 54% are white and 35% are black, with 5% Asian. About 55% are women and 4% are Hispanic.

Children and youth up to age 19 make up 43% of the Medicaid population, followed by adults ages 35-64 at 29% and people ages 20-34 at 22%.

The profile is a little different for the more than 650,000 Virginians who joined the program under new eligibility standards that came into effect. January 1, 2019, to expand Medicaid under “Obamacare” to include childless adults for the first time. About 45% of these beneficiaries are between 19 and 34 years old and 37% between 35 and 54 years old.

The overwhelming majority of people in the expanding population – more than 485,000 – earn less than the federal poverty level, which is $12,140 one year for a single person and $20,780 for a family of three. About 169,000 earned between 100% and 138% of the poverty line, or up to $16,775 for a single person and $28,676 for a family of three.

Where do they live? More than 511,000 Medicaid beneficiaries live in the state Central region: of which about 85,000 in richmondnearly 81,000 each in Henrico and Chesterfield counties, and nearly 16,000 in County of Hanover.

The largest number of beneficiaries live in from Virginia most populated locality Fairfax Countywith more than 165,000, followed by Prince William County with nearly 103,000.

Medicaid is an expensive program, over $19 billion per year, divided between the federal government and the state governments. They’ve split the cost roughly 50-50 for the base Medicaid population, but the feds are paying 90% of the cost for those enrolled under the expansion, with a provider tax on hospitals covering the part of the State within the framework of the budgetary agreement on General assembly adopted in 2018.

Nearly 49% of the cost covers the elderly, disabled, and pregnant women, who make up just 18% of the Medicaid population.

So why Virginia do you need to redetermine the eligibility of the 2 million people enrolled in the program?

After the start of the pandemic in March 2020, Congress passed the Families First Coronavirus Relief Act, the first in a series of emergency funding bills that provided a higher federal matching share to pay for state Medicaid programs. In Virginiait was 6.2% more, more than $1 billion until September.

In return, the state couldn’t kick people off the Medicaid rolls, even if they no longer met the eligibility requirements. Once the federal government ends the public health emergency, states must begin re-determining eligibility, and as soon as 1st of Augustthey can remove people from the program.

the US Department of Health and Human Services is expected to decide by Monday whether to end the public health emergency or extend it for another quarter of the fiscal year, until September. The government has promised to give states at least 60 days notice before ending the emergency.

Once Virginia begins to unwind the program by redetermining eligibility, the state and its partners will look for ways to ensure people continue to have health care coverage.

“Our fear is that there will be eligible people falling through the cracks,” said Debbie Oswaltgeneral manager of the Virginia Health Care Foundationwhich works to expand health coverage and reduce the number of uninsured Virginians.

Many will reapply for Medicaid coverage if they remain eligible. Some will be covered by federally subsidized market-based insurance premiums that the federal government currently runs – the state will take over in early 2024. Others who have secured employment will obtain private insurance through the intermediary of their employer. And some will become eligible for Medicare when they turn 65.

Virginia Poverty Law Center will be in the midst of these efforts to find health care coverage for people who may no longer qualify for Medicaid. The center, based in richmond, employs 23 “navigators” across the state in the Virginia ENROLL! program, which helps guide people through the process of finding affordable health insurance.

“We expect a lot of work to help people find their place,” said Sara CarianoPolicy Specialist and Senior Health Insurance Navigator at the Legal Center.

The six managed care companies that provide health care coverage through Medicaid in Virginia also plan to help people find affordable insurance.

“This is a special initiative where we want to maintain continuity of care for people,” Gray told the health plans association.

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