Medicaid Matters. It’s a lifeline for millions of Americans and is especially critical as the nation responds to the pandemic, providing key funding for hospitals and helping patients get the support they need.
Medicaid is the country’s most extensive health care program specifically designed to meet the needs of low-income individuals who have disproportionate medical needs and health challenges. Medicaid provides high-quality, affordable coverage to nearly 80 million low-income individuals and families, including 10 million people with disabilities. The program is the main source of long-term care coverage for millions of older adults and, along with the Children’s Health Insurance Program (CHIP), provides access to care for over 40 million children.
One of the key goals of Medicaid Awareness Month is to raise understanding about the program and the services it provides. Many people may not realize that they are eligible for Medicaid or may not be aware of the range of services that are covered. By increasing awareness, we can help ensure that more people are able to access the care they need to stay healthy.
It has been proven that Medicaid expansion efforts have increased access to care, improved financial security and led to better health outcomes. The Medicaid expansion has played a pivotal role in reducing racial disparities in obtaining healthcare access.
The Public Health Emergency (PHE) is set to expire on May 11, 2023. The PHE has been in place since 2020 due to the Covid-19 pandemic. During this time, Medicaid/CHIP enrollment grew by more than 20 million. The PHE gave the federal government flexibility to waive or modify Medicaid and CHIP programs. Starting this Spring, States will begin the process to determine who will no longer be eligible for coverage. It is estimated that up to 15 million Medicaid and CHIP enrollees will lose coverage over the next 12 months.
It is expected that up to a third of those losing coverage will turn to Health Insurance Exchange Marketplaces. Consumers who have lost coverage during the Medicaid unwinding process will be eligible to apply for immediate coverage through a Special Enrollment Period (SEP). While many Issuers are scrambling to replace lost Medicaid revenue, ACA Marketplaces are a strategic place to look.
At ProspHire, our approach is to gain a fundamental understanding of your existing business, operations and goals and then develop the best strategy to achieve your ACA goals quickly and effectively. We can assist your health plan with conducting an assessment and instituting change management throughout the Medicaid unwinding’s and help to ensure ACA and other products are optimized to secure continued coverage for those losing Medicaid.