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Medicaid renewals: Those who don't reenroll could get kicked off


Millions of Americans could lose their health insurance over the coming months.


That's because a federal rule that protected people's Medicaid coverage during the pandemic expires this Friday at midnight.

PFEIFFER: NPR health correspondent Maria Godoy is with us with details. Hi, Maria.


PFEIFFER: Why is this happening?

GODOY: Well, it's the end of a pandemic-era protection. So Medicaid is the public health insurance program for low-income people. Before the pandemic, they had to reenroll every year, and it's a big red tape hassle. People often got dropped even if they did qualify for coverage. And a lot of times, they only found this out when they showed up at the ER or they went to the pharmacy to refill a prescription, and they were told you're no longer covered.

PFEIFFER: That sounds like a very inefficient system.

GODOY: Well, right. So back in 2020, lawmakers passed this rule that prevented states from dropping people from Medicaid, but that protection ends on March 31.

PFEIFFER: Maria, how many millions of people are on Medicaid, and what does it mean for them?

GODOY: Well, there's roughly 85 million people on Medicaid, and every one of them is going to have to reenroll to keep their benefits. But to be clear, it's not going to happen all at once. States are going to start sending out notices to people telling them when it's time to reenroll. Some states are asking people now to submit paperwork to prove they're still eligible. Some people might be getting termination notices on April 1, although they can appeal. But the problem is not everyone is going to get these notices or complete the paperwork on time.

PFEIFFER: This sounds like a major administrative undertaking and potentially chaotic.

GODOY: Right. It's massive because if you think about it, it's been three whole years since people had to renew Medicaid. Now there's more people than ever on the program. A lot of people have moved since the pandemic. Maybe they didn't update their contact information, so they're not going to get those renewal notices from the state. I spoke with Elizabeth Edwards. She's with an advocacy group, the National Health Law Program. She told me Medicaid offices in many states are understaffed and just overwhelmed.

ELIZABETH EDWARDS: Advocates are starting to see problems at call centers with long wait times, as well as call centers just stopping accepting calls because they have enough for the day or they're closed on a certain day to catch up on work.

GODOY: And, you know, roughly 1 in 4 Americans are on Medicaid right now. So that's a lot of people to process.

PFEIFFER: Right, about a quarter of the country. So, Maria, for people going through this and trying to keep their coverage, what are some other roadblocks they might run into when trying to reenroll?

GODOY: Well, there's concern about people with limited English and also those with disabilities. Certain disabilities qualify you for Medicaid. But Edwards says some of the renewal paperwork in some states isn't asking the right questions that can flag conditions that might qualify someone. She says they're also seeing problems with notices that don't tell people why they lost coverage. And if you don't know why, it makes it really hard to appeal.

PFEIFFER: You're describing what could be enormous upheaval in people's lives that they may not even know is coming.

GODOY: Right. And, you know, there's a real human impact here that I don't want to be missed. Especially if you have a chronic health condition, a gap in coverage could be incredibly disruptive. Estimates suggest as many as 18 million people are going to lose coverage during this process.

PFEIFFER: So in terms of helping people, is there anything that people going through reenrollment can do to make this process go more smoothly?

GODOY: Yeah. So make sure your contact information is up to date with your state or local Medicaid agency or the insurance company that runs Medicaid in your state. And please watch your mail for renewal notices.

PFEIFFER: Thank you for those tips. That is NPR health correspondent Maria Godoy.

GODOY: My pleasure. Transcript provided by NPR, Copyright NPR.

Maria Godoy is a senior science and health editor and correspondent with NPR News. Her reporting can be heard across NPR's news shows and podcasts. She is also one of the hosts of NPR's Life Kit.
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