Health centers sound the alarm over withdrawal of Medicaid coverage after public health emergency

Dive brief:

  • Health centers say the withdrawal of government actions that boosted Medicaid coverage during the pandemic after the expiration of the COVID-19 public health emergency, according to a new investigation by the National Association of Community Health Centers, could significantly reduce patient care.
  • Almost all of the health center respondents (90%) said that due to increased Medicaid registrations and other regulatory flexibilities, they were able to provide more services to patients who would otherwise have were deprived of care, while 87% said they were able to treat more patients overall. .
  • But those benefits are threatened if these policies are not extended beyond the PHE, the health centers said. More than 90% of those polled said ending Medicaid flexibilities would result in patients forgoing needed health services. Many others said their patients should instead rely on emergency and emergency services for medical care. The repercussions of losing access to low-cost preventive care would be particularly severe for patients with chronic diseases and others with expensive medical needs, the NACHC said.

Dive overview:

Despite the economic recession of COVID-19 last year, excluding millions of Americans from employer-sponsored insurance, the Medicaid safety net, and individual exchanges put in place by the Human Rights Act. Affordable care has kept the country’s insurance rate stable.

CMS data shows Medicaid enrollments alone increased by more than 11 million people – a 16% increase – from February 2020 to April 2021, spurred in part by more flexible regulations put in place during the pandemic.

As part of the Family First Coronavirus Response Act passed last March, states began receiving a 6.2% increase in the federal Medicaid match rate. In return for the higher federal funding, states are not allowed to deregister Medicaid recipients during the PHE.

This requirement for continued coverage has helped make Medicaid the largest source of insurance coverage in the United States.

“Unless these policies to keep people enrolled in Medicaid coverage continue or are extended, Medicaid beneficiaries will lose their benefits, pay more for health care, or forgo care, putting the safety net. at risk, ”the NACHC said, noting patients in the 12 states that have yet to expand Medicaid will be particularly affected.

The NACHC surveyed federally qualified health centers, federally funded not-for-profit clinics, in September to determine how the loss of Medicaid flexibilities will affect their operations and the health of their patients. The approximately 1,400 FQHC nationwide serve nearly 29 million people, including one in five Medicaid recipients and one in three low-income Americans.

Before the pandemic, 48% of health center patients were beneficiaries of Medicaid and the children’s health insurance program, but this has increased significantly compared to the PHE. Most health centers have reported up to 25% increase in the number of Medicaid patients.

Almost all health centers reported treating more patients who would otherwise have to go to an emergency room or forgo care altogether.

A third of health centers were able to treat more children, while half say they were able to prevent the onset or worsening of chronic diseases. Many health centers are also reporting that telehealth, which also benefited from more flexible regulations from Washington, was a valuable tool in reaching more patients and providing more services during PHE.

NACHC said members of its health center feared people with Medicaid coverage would be found ineligible and lose insurance once states revert to pre-COVID-19 Medicaid policies and eligibility. .

Rebecca Pifer / Healthcare Dive, NACHC survey data

The Biden administration recently extended the time frame for states to complete pending eligibility and enrollment actions up to 12 months after the end of the PHE, and asked states to make an additional re-determination for anyone found to be newly ineligible. But that’s not enough, said the NACHC.

The group argues that in addition to codifying telehealth flexibilities, Congress should take a number of steps to protect Medicaid coverage, many of which are already being considered.

This involves giving states more clarity on the expected gradual reduction of their 6.2% increase in FMAP, establishing strict eligibility reassessment standards that states must follow, as well as sanctions for states. who are trying to reduce Medicaid eligibility before 2025, and strengthen ACA grants and market enrollment periods to help people in non-Medicaid expansion states.

Maria J. Book