Here’s why an estimated 500,000 Arizonans are at risk of losing their Medicaid coverage

The Families First Coronavirus Response Act prevented Arizona and other states that accepted increased federal Medicaid matching dollars during the pandemic from dropping anyone who was enrolled as of March 18, 2020. States that accepted the enhanced funding also couldn’t remove any new enrollees, either.

But the freeze on kicking people off of Medicaid was always set to end once the national public health emergency declaration ends, which is expected to happen in the next few months. The exact date remains unknown.

Millions of Americans across the U.S. who are enrolled in Medicaid could be affected and a March 9 analysis from the Robert Wood Johnson Foundation and the Urban Institute found that people losing Medicaid coverage after the public health emergency ends will be at risk of becoming uninsured.

“As families continue to face health and economic consequences of the ongoing pandemic, large-scale, rapid Medicaid disenrollment could have serious effects on the well-being of millions of people,” Matthew Buettgens, Urban Institute senior fellow, said in a written statement when the analysis was released.

That’s why officials with the Arizona Health Care Cost Containment System, which is Arizona’s $18 billion Medicaid program, are urging enrolled Arizonans to take action now to avoid losing coverage.

An estimated 500,000 of the 2.37 million Arizonans enrolled in AHCCCS are at risk of either no longer meeting eligibility criteria once the public health emergency ends or of being disenrolled because they have not responded to the agency’s requests for additional information, AHCCCS spokeswoman Heidi Capriotti said.

“Members will only be disenrolled if they no longer meet eligibility requirements or do not respond to our requests for more information through the renewal process,” Capriotti wrote in an email.

AHCCCS officials are urging enrollees to respond immediately if they are contacted by AHCCCS, and to check with the state to make sure their address is up to date. Some Arizonans who may be earning too much money to still qualify for AHCCCS could be eligible for subsidized health insurance via the Affordable Care Act (also known as Obamacare).

“Soon, Medicaid and KidsCare disenrollments will begin again,” says a March 15 AHCCCS news release. “This means some people with Medicaid or KidsCare coverage could be disenrolled from those programs because they no longer meet financial or medical eligibility requirements.”

KidsCare, which is operated by AHCCCS, is Arizona’s version of the federal Children’s Health Insurance Program, known as CHIP, for children in families who earn too much to qualify for regular AHCCCS coverage, but not enough to be able to afford private insurance. 

CHIP was created in 1997 with bipartisan support during President Bill Clinton's administration at a time when the rate of uninsured children in the country was 14 percent. After CHIP passed, the rate of uninsured children declined significantly.

A Georgetown University report released in February estimated that at least 6.7 million children nationwide are likely to lose their Medicaid coverage and are at “considerable risk” for becoming uninsured for some period of time after the national public health emergency ends.

Children could lose coverage in one of two ways: they could become eligible for another public coverage program (most likely CHIP) and get lost in transition; or they could remain eligible for Medicaid but still lose their coverage for procedural reasons, such as not responding to a mailed request for verification by the state that may have gone to the wrong address, the report’s authors found.

Nearly one in three Arizonans is enrolled in Medicaid or KidsCare. 

Normally, Arizonans must renew their enrollment in AHCCCS annually to make sure they are still meeting eligibility requirements. That changed during the pandemic and the number of people enrolled in the program swelled both in Arizona and the U.S.

Enrollment in AHCCCS (including KidsCare) is at an all-time high level, with 2.37 million enrollees as of this month, representing close to one in every three Arizona residents using the most recent U.S. Census data that says Arizona’s population is 7.28 million.

More than half of the people enrolled in AHCCCS as of January (55%) were working-age people between the ages of 18 and 64, and 38.2% were children under the age of 18, which works out to 869,654 kids. A smaller percentage, 6.4%, were older adults over the age of 65.

Nationally, enrollment in Medicaid (including the Children’s Health Insurance Program) also climbed during the pandemic with a total of 84.8 enrollees as of September 2021, which works out to about one in every four Americans.

Medicaid is a government health insurance program for low-income people. Eligibility varies somewhat between various adult and child categories but generally for an adult, the qualifying household income is $18,084 per year or less.

Total AHCCCS enrollment has been steadily increasing throughout the pandemic and first hit 2 million in June 2020. The nearly 2.4 million number of beneficiaries is a record-high level for the Arizona program, which launched in 1982.

Shifting public policies over the years have caused the enrollment numbers to shrink and expand. In 1985, AHCCCS enrolled 144,450 people.

Arizona’s Medicaid expansion in 2013 restored childless adults to AHCCCS and increased income limits, which resulted in a larger AHCCCS population.

The pandemic fueled even more growth in AHCCCS numbers. Not only was there a freeze on disenrolling people, but many individuals lost jobs, income and health insurance during the pandemic, which could have made them eligible for AHCCCS.

The number of uninsured people in Arizona could increase once the public health emergency ends, said Dr. Daniel Derksen a public health professor and director of the Center for Rural Health at the University of Arizona's Mel and Enid Zuckerman College of Public Health.

Derksen estimates roughly 700,000 Arizonans don't have health insurance, which is close to 10% of the population. 

On the positive side, AHCCCS officials appear committed to ensuring enrollees are aware that the suspension on disenrollment is expected to end soon, Derksen said, which could help minimize the number of people who lose coverage. 

How AHCCCS enrollees can ensure they keep their health coverage

There are three key ways for people enrolled in AHCCCS to make sure they don't lose coverage:

• Ensure that their mailing address, phone number and email address on file is correct by logging on to www.healthearizonaplus.gov (or by calling Health-e-Arizona Plus at 855-HEA-PLUS (855-432-7587), Monday through Friday 7 a.m. - 6 p.m.)
• Check their mailbox for a letter from AHCCCS about renewal of coverage.
• Respond to any requests from AHCCCS for more information so the agency can accurately determine eligibility.

Anyone who earns too much money to qualify for AHCCCS may be eligible for subsidized private health insurance through Affordable Care Act marketplaces. Buy ACA insurance through healthcare.gov or CuidadoDeSalud.gov or at 800-318-2596.

Licensed and certified health insurance navigators and certified application counselors in both English and Spanish can offer help free of charge to Arizonans. Information is available by calling Cover Arizona at 800-377-3536 or by going to www.coveraz.org.

Reach the reporter at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes.