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A look ahead

Monday, Mar 20, 2023 - Posted by Rich Miller

* There’s a lot more to this story, but here are a few highlights of Marni Pyke’s piece on what happens when the public health emergency declaration ends in May

But pulling the plug on federal and state public health emergencies, which enabled actions such as setting up mass vaccination sites, is not without repercussions. They include thousands losing Medicaid, no more at-home COVID-19 test reimbursements for many, and general confusion. […]

Federal data indicates up to 700,000 statewide could fall off Medicaid, but the Illinois Department of Healthcare and Family Services estimates it’s closer to 384,000.

“The truth is, nobody knows for sure,” department spokeswoman Jamie Munks said. “What we do know is that we are committed to ensuring everyone who is eligible maintains their coverage, and that those who are deemed ineligible are given information about finding alternative coverage.” […]

But one major shift with over-the-counter tests is that private insurance companies will no longer have to offer reimbursements, although some may opt to continue. […]

The public health emergencies broadened the use of virtual doctor visits during the pandemic, and experts said telehealth won’t go away when they end.

The Medicaid issue is probably the most dramatic.

* From the Illinois Association of Medicaid Health Plans

Beginning at the end of April, Medicaid enrollees in Illinois will start to receive information to renew their healthcare benefits as part of the nationwide redetermination process. However, a new study shows that there is significant opportunity for Medicaid enrollee education on the redetermination process.

This is in part due to the fact that Medicaid enrollees have not been asked to update their information, or renew their coverage, for three years. The process, that would usually occur at least once a year for Medicaid enrollees, was put on pause due to the COVID-19 pandemic. Now that Congress has set an end to the public health emergency, that renewal process, or redeterminations, is resuming.

Although nationwide, Congress has declared that April 1st will mark the start of redeterminations, state officials in Illinois will begin sending correspondence out to Medicaid members at the end of April. This entire process will take twelve months to complete, with enrollees being redetermined iteratively - not everyone will be renewing their benefits at the same time.

“This is really important to note as there are so many misconceptions and misinformation circulating about the redeterminations process here in Illinois,” said Samantha Olds Frey, CEO of the Illinois Association of Medicaid Health Plans, a trade association that represents the Medicaid Managed Care Organizations that provide Medicaid coverage in Illinois. […]

What Illinois Medicaid enrollees should know is that beginning at the end of April, they could expect to receive correspondence from the Illinois Department of Human Services (IDHS) regarding submitting information to determine their eligibility. They must submit the requested information by the given due date they are provided with. If they miss the deadline, they risk losing their health coverage.

If they are no longer eligible for coverage, they have options to sign up for a marketplace plan. Their current Medicaid Managed Care Health Plan can assist them with this process. […]

The likelihood of losing healthcare coverage is even higher with those who have chronic health conditions or who have an increased risk related to social influencers of health because they are more focused on health issues than returning redetermination paperwork. Considering the disproportionate impact of chronic health conditions on Black and Brown communities, there is a huge concern about loss of coverage for those who are still eligible for Medicaid within those communities.

…Adding… Rep. Bob Morgan says he’s been working to broker a deal on temporary healthcare workers losing their licenses. He’ll be moving this bill this week, he said.

       

6 Comments
  1. - cermak_rd - Monday, Mar 20, 23 @ 10:30 am:

    If they haven’t done redetermination for 3 years, do they even have current address information on people? And while I understand the rolling dates, that could cause problems too as it could be that the way people find out about this is via social media or church or… and if it’s not a common date that could cause confusion.


  2. - Perrid - Monday, Mar 20, 23 @ 11:00 am:

    Not having valid contact info has always been a problem with redeterminations, it’s only going to be larger now that years have gone by.


  3. - Dan Johnson - Monday, Mar 20, 23 @ 11:03 am:

    I wonder how much we all collectively spend on redetermination / enrollment / eligibility paperwork and admin and hassle. Basically wasted. Medicaid should just be a blanket floor everyone is entitled to. And if you want to buy more coverage or pay cash for more services, feel free.


  4. - New Day - Monday, Mar 20, 23 @ 11:06 am:

    Watch for the number of uninsured to rise significantly as millions lose their Medicaid coverage. Illinois is working really hard on this issue and we’re estimated to lose almost 400,000 from the rolls. Imagine what’s happening in reluctant Medicaid states. Say what you will about government largesse, but we all benefit when people have health care coverage of some kind.


  5. - thechampaignlife - Monday, Mar 20, 23 @ 2:20 pm:

    I am curious if the free school lunches for all students in a district will end in May as well. Not sure if that is just a Champaign thing, or at all related to the pandemic, but it has been great for families.


  6. - Eric Bergman - Monday, Mar 20, 23 @ 8:39 pm:

    Rep Morgan need not broker a deal for temporary/travel nurses. The Nurse Licensure Compact (SB41) would recognize nurses licensed in any of the 39 other jurisdictions in the compact. The unions who have effectively blocked this legislation so far are doing so to try to leverage a different issue and harming IL and the majority of our nurses. The compact helps the majority of nurses and certainly many residents. There are a huge number of benefits to passing the nurse licensure compact in IL beyond solving this crisis.


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