1 00:00:03,400 --> 00:00:08,366 each year to renew their coverage. But that# stopped during the onset of the 2 00:00:08,366 --> 00:00:12,333 An d, for three years, recipients# have been continuously enrolled.## 3 00:00:12,333 --> 00:00:16,066 But that reenrollment provision# ended in April. And, since then,## 4 00:00:16,066 --> 00:00:19,866 more than 15 million people have# been disenrolled from Medicaid. 5 00:00:19,866 --> 00:00:21,766 We're joined now by Jennifer Tolbert,## 6 00:00:21,766 --> 00:00:26,633 deputy director of the Program on# 7 00:00:26,633 --> 00:00:27,600 Thank you for being with us. 8 00:00:27,600 --> 00:00:30,800 So, Jennifer 9 00:00:30,800 --> 00:00:35,700 people forgetting to reenroll# or is something else at play? 10 00:00:35,700 --> 00:00:36,333 JENNIFER TOLBERT, Deputy Director, Program on# Medicaid and the Uninsured, KFF: Well, I think## 11 00:00:36,333 --> 00:00:39,300 it 12 00:00:39,300 --> 00:00:45,900 So, because states kept people on the Medicaid# program for three 13 00:00:45,900 --> 00:00:49,766 there are a number of people who# have had changes in circumstances,## 14 00:00:49,766 --> 00:00:54,133 they have gotten new jobs, they have# increased their hours at their existing jobs,## 15 00:00:54,133 --> 00:00:58,900 and because of that increase in# income, are no longer eligible. 16 00:00:58,900 --> 00:01:05,200 But we also know that there are a lot of people# who are losing coverage for what are called## 17 00:01:05,200 --> 00:01:12,100 procedural or paperwork reasons. And this is# a situation in which the state is disenrolling## 18 00:01:12,100 --> 00:01:19,433 someone, even though they don't have information# to confirm whether the person is still eligible. 19 00:01:19,433 --> 00:01:21,600 GEOFF BENNETT: And who is# most affected by that? And## 20 00:01:21,600 --> 00:01:26,766 what about children who are covered# by M 21 00:01:26,766 --> 00:01:30,066 JENNIFER TOLBERT: Yes, we're seeing a# lot of disenrollments among children. 22 00:01:30,066 --> 00:01:35,666 I think going into this process, the assumption# was because Medicaid el 23 00:01:35,666 --> 00:01:42,600 higher than that for adults, that there would be# fewer disenrollments among children. But among## 24 00:01:42,600 --> 00:01:48,100 reporting states, and we only have data from# about 23 states, but among those states showing## 25 00:01:48,100 --> 00:01:55,500 disenrollments broken out by age, children account# for nearly 40 percent of all disenrollments. 26 00:01:55,500 --> 00:02:01,033 And so, nationally, that translates to# about five million children losing coverage. 27 00:02:01,033 --> 00:02:06,600 GEOFF BENNETT: And when people lose coverage, what# exactly are they losing? What's at stake here? 28 00:02:06,600 --> 00:02:10,333 JENNIFER TOLBERT: Yes, well, they're# losing their access to medical care.## 29 00:02:10,333 --> 00:02:15,566 And many people on Medicaid are dealing# with chronic health conditions or mental## 30 00:02:15,566 --> 00:02:21,733 health issues for which they need# ongoing medication and treatment. 31 00:02:21,733 --> 00:02:27,600 And particularly for kids, this can mean# losing access to needed medications to## 32 00:02:27,600 --> 00:02:36,800 control ADHD or to help with autism or# diabetes. And so losing Medicaid coverage,## 33 00:02:36,800 --> 00:02:43,533 even if it may be for a short period while# someone is trying to get reenrolled, can lead## 34 00:02:43,533 --> 00:02:51,100 to lapses in care, so people not being able to# get needed medications, not being able to see## 35 00:02:51,100 --> 00:02:58,233 doctors or therapists that can help them control# whatever health care issue they're dealing with. 36 00:02:58,233 --> 00:03:02,600 GEOFF BENNETT: You know, looking at the numbers,# there is a wide range of disenrollment rates## 37 00:03:02,600 --> 00:03:09,366 across the country, 61 percent in Texas to# 13 percent in Maine and Oregon. Why is that? 38 00:03:09,366 --> 00:03:13,200 JENNIFER TOLBERT: Yes, there are a# lot of different factors at play here. 39 00:03:13,200 --> 00:03:18,666 Some of it has to do with when states# started disenrolling people. Some states## 40 00:03:18,666 --> 00:03:26,566 started earlier than others. Other states# have taken greater steps to try and ensure## 41 00:03:26,566 --> 00:03:31,933 that people who are still eligible remain# on the program. So one thing that states## 42 00:03:31,933 --> 00:03:38,500 are doing or required to do, in fact, is to# conduct what are called ex parte reviews. 43 00:03:38,500 --> 00:03:42,866 And this is where state checks# available data sources to see## 44 00:03:42,866 --> 00:03:47,766 if an individual continues to qualify# for Medicaid before they send a renewal## 45 00:03:47,766 --> 00:03:54,300 notice asking someone to complete forms# and provide other documentation. States## 46 00:03:54,300 --> 00:04:00,900 that have higher ex parte renewal rates# tend to have lower disenrollment rates,## 47 00:04:00,900 --> 00:04:08,066 because they are able to enroll or renew more# people without asking people to take action,## 48 00:04:08,066 --> 00:04:13,333 which can be burdensome, or which can lead# to problems like people not receiving notices## 49 00:04:13,333 --> 00:04:19,833 in the mail or not being able to gather the# required documents that the state is requesting. 50 00:04:19,833 --> 00:04:25,100 GEOFF BENNETT: If someone believes that they have# been improperly disenrolled, what can they do? 51 00:04:25,100 --> 00:04:31,000 JENNIFER TOLBERT: Yes. 52 00:04:31,000 --> 00:04:36,133 unfortunately, this can be difficult in# many states because there are still long## 53 00:04:36,133 --> 00:04:42,000 wait times for many call centers# when people try and get through. 54 00:04:42,000 --> 00:04:47,900 But my advice is to stay patient and# continue to try and get through to## 55 00:04:47,900 --> 00:04:55,133 the Medicaid agency. If not that, there are# community-based organizations and entities## 56 00:04:55,133 --> 00:05:01,600 called navigators and enrollment assisters# that can provide people with help to complete## 57 00:05:01,600 --> 00:05:09,233 their renewal process or to challenge if they# think they have been improperly disenrolled. 58 00:05:09,233 --> 00:05:13,700 GEOFF BENNETT: Jennifer Tolbert with KFF, thanks# so much for your insights. We appreciate it. 59 00:05:13,700 --> 00:05:25,033 JENNIFER TOLBERT: Thank you.