Why So Many Hoosiers Could Lose Their Medicaid Coverage This Year

Why So Many Hoosiers Could Lose Their Medicaid Coverage This Year

July 5, 2023

By Xain Ballenger, TheStatehouseFile.com

More than 100,000 Hoosiers have lost their Medicaid coverage as the state returns to pre-pandemic operations and requires recipients to verify their eligibility. 

At the start of the COVID-19 pandemic, the U.S. government stopped the periodic review process and mandated that recipients of Medicaid be kept on it. 

However, since the public health emergency has ended, Indiana Medicaid recipients are again having to show their eligibility by going through the redetermination process as from before the pandemic. This is what states use to determine who is enrolled in Medicaid and how they can continue to be eligible for it.   

According to data from the Centers for Medicare and Medicaid Services, 323,119 Hoosiers were up for Medicaid renewal in April and May. A total of 52,985 lost their coverage in April and another 53,684 lost coverage in May.

Indiana instituted this process in April of this year by sending a series of letters and a redetermination packet to upwards of 500,000 Hoosiers whom the Family and Social Services Administration (FSSA) identified as needing to show their eligibility for Medicaid. 

Hoosiers are given 45 days to return the packet; however, if the recipients fail to meet their deadline, Indiana offers a 90-day grace period during which recipients can re-enroll in Medicaid without having to go through the application process. 

Michele Holtkamp, director of communications and media at FSSA, said in an email that the redetermination process can be as simple as taking “no action.” This is because the state has access to data that can inform FSSA if the member is still eligible or if the person needs to provide updated information to determine eligibility. 

Medicaid provides benefits to individuals who have low incomes.

The federal government established general guidelines for these benefits, but the eligibility requirements to receive them are determined by individual states. To be eligible for Medicaid in Indiana, a person must be a resident of the state, a United States citizen or legal immigrant, and qualify as low-income. 

A press release also said that Indiana’s high rate of dis-enrollments was due to errors in paperwork rather than ineligibility. This means that if a person fails to provide enough information to FSSA or the government and so cannot be verified, then the person could be disenrolled. This is what’s considered a procedural dis-enrollment.

“For these cases, current documentation was missing or indicated ineligibility.  The renewal form allows Medicaid members to submit information to show they continue to be eligible for another year of benefits; in these cases, all of the needed information was not submitted by the individual and the state could not make a determination of continued eligibility,” Holtkamp said.

Tracey Hutchings-Goetz, the communications and policy director for Hoosier Action, a nonpartisan community organization out of Southern Indiana, spoke to this issue. She described it as a paperwork error but said that this doesn’t mean the state made a mistake or the person is no longer eligible for Medicaid. She said that no one replied, so the state didn’t have enough information or paperwork to prove the person is still eligible. 

According to “Strengthening Medicaid: Challenges States Must Address as the Public Health Emergency Ends,” a Hoosier Action Medicaid survey, 34.7% of Hoosiers were unaware that they needed to renew their coverage when the public health emergency ended. It also said that a reported 42.5%  went without needed medical treatment in the past year. Finally, 65.3% of Hoosiers reported having problems when accessing these services.