Alabamians who received Medicaid during COVID-19 could lose health coverage this spring when pandemic protective measures end.
Pandemic-era protections that have prevented states from removing ineligible people from Medicaid rolls will expire starting in April of this year. As a result, about 61,000 Alabamians are expected to lose their Medicaid coverage by June 2024, according to a report by the Robert Wood Johnson Foundation and the Urban Institute.
States can begin dropping people who are no longer eligible due to a change in income, if they haven’t updated the state on a change of address or for other reasons as early as April 2023 This continues until June 2024.
Jennifer Harris, health policy advocate for the nonprofit advocacy group Alabama Arise, said she’s concerned that some people who may not realize their insurance is ending or that they need to take steps to avoid losing their Medicaid will fall through the cracks during the process.
“A lot of people may not know about Medicaid eligibility and how Medicaid determines eligibility each year versus ‘I got Medicaid during the public health emergency, and I never understood , or it was never made clear to me, that normally it would not be continuous over several years,” she said.
Harris is the chair of the Alabama Medicaid Endgame Task Force, which has worked with state Medicaid officials to try to prevent such problems when coverages end in April.
For some Alabamians, language barriers can be a problem understanding the changes, Harris said. For others who have changed their address, they may not realize that they need to update the status of their new address to maintain their health coverage through Medicaid.
Alabama is expected to see its number of uninsured residents increase by 16%, according to the report by the Robert Wood Johnson Foundation and the Urban Institute. In June 2024, Alabama would have a total of 432,000 uninsured residents.
“Those most likely to move in and out of Medicaid eligibility are young adults, part-time workers, and people whose incomes are close to eligibility thresholds,” the report said.
People who receive letters saying they are no longer eligible for Medicaid coverage can appeal the decision. For those who lose coverage, their options would be to buy insurance in the federal health care market or get it through work if they can. Children will be eligible for ALL Kids insurance, and their parents should receive a letter with the option of having their coverage renewed, according to Harris.
In Alabama, a family of two earning more than $3,300 a year is not eligible for Medicaid. A family member must also be the primary caregiver for the children to qualify.
Some states have expanded Medicaid to close this coverage gap, but Alabama has not.
Many people in minimum-wage jobs who don’t have workplace health insurance earn too much to qualify for Medicaid, but too little to afford health care elsewhere, she said.
“Some people won’t have affordable options even in the (federal) market,” Harris said.