15 million could lose Medicaid coverage in "unwinding" process

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15 million could lose Medicaid coverage in 'unwinding'

An estimated 15 million people are expected to lose their Medicaid coverage, including one million Texans, now that Medicaid "unwinding" has begun. That means the COVID public health emergency is ending and automatic re-enrollment set up during the pandemic has ended. FOX 26 Consumer Reporter Heather Sullivan shares some Smart Sense on what recipients need to know.

An estimated 15 million people are expected to lose their Medicaid coverage, including one million Texans, now that Medicaid "unwinding" has begun.

That means the COVID public health emergency is ending and automatic re-enrollment set up during the pandemic has ended.

Medicaid recipients must now re-apply for the first time in three years, but many may not find out until they need a doctor and discover their coverage is gone.

Lizbeth Landaverde's two boys already keep her busy. "I’m pregnant again with another little boy," she told us.  

Having Medicaid health coverage gives her peace of mind.

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"It helps me because I’m a stay-at-home mom. We only have one income," said Landeverde.

Millions of people are expected to lose Medicaid coverage, either temporarily or permanently, through what's called Medicaid unwinding.

That's leaving healthcare providers, like those at AccessHealth, concerned about their patients and working to make sure they are notified, particularly pregnant mothers who could lose continuous coverage after childbirth.

"We see morbidity and mortality for postpartum women. Women and children need to get the best possible care, especially in minority communities. That’s what we’re worried about," explained Palak Jalan with AccessHealth.

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Millions of recipients are expected to lose Medicaid coverage in a coverage gap, perhaps because they've moved and won't receive the notice to renew, or because they now earn too much income to qualify.

"What that means is if their documents are missing, or they're at a different address, or they're not eligible anymore, they tend to lose their coverage," said Jalan.

Pregnant mothers had continuous Medicaid coverage after childbirth during the pandemic, but in Texas, it now reverts to ending two months after childbirth.

"It’s the medical health checkups, but you also think of mental health, and how postpartum depression plagues women," said Jalan.

Doctors say coverage loss could impact patients with chronic illnesses, like diabetes or high blood pressure, or who need surgery, and families like Landeverde's who depend on Medicaid.

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"I know they’re taken care of.  They’re good, they’re healthy," said Landeverde.

Medicaid recipients should make sure their contact information is up-to-date on YourTexasBenefits.com, where they can also apply for a renewal of benefits. The process can take a couple of months.

That's why the state set up the Texas Community Partner Program. Enter your zip code and the site will list local Medicaid managed care plans that can help with applications. AccessHealth says it can complete the process in just 3 to 5 days.

Recipients who no longer qualify for Medicaid may be able to find coverage through other options, such as the Affordable Care Act marketplace, CHIP, or Healthy Texas Women.