Medicaid cuts off 148K Michiganders in review; cancer patients get reprieve

• Michigan’s Medicaid programs exploded to an unprecedented 3.2 million beneficiaries during the pandemic.
• Now, one in three are losing coverage, but it’s mostly because they have not submitted documentation to prove they’re eligible, advocates say.
• Cancer patients will keep coverage with no questions asked, at least for now.

More than 147,000 Michiganders so far have lost Medicaid coverage, two months into a year-long process to reexamine each case.

But the Whitmer administration has extended a lifeline, at least for now, for more than 6,000 patients undergoing cancer treatment.

Those patients receiving life-saving medical treatment will receive Medicaid coverage through May — no questions asked, as the state continues its review of more than 3.2 million cases.

Related:

• Over 80,000 Michigan residents lost Medicaid benefits in first month
• Thousands of Michiganders could lose Medicaid coverage if they miss the mail
• Thousands on Michigan Medicaid will keep coverage for at least another month
• Michigan’s Medicaid ballooned during COVID. It’s about to be pared back

It’s the latest move by the Whitmer administration as it tries to continue Medicaid coverage to as many Michiganders as possible, even as it is under a federal directive to reevaluate eligibility for all Medicaid beneficiaries. Consumer advocates have repeatedly warned that many people on Medicaid are difficult to track down, and may miss messages that they have to prove their continued eligibility.

As of Wednesday, at least 7.1 million enrollees had been disenrolled based on the most current data from 48 states and the District of Columbia, according to the San Francisco-based KFF.

Those beneficiaries may not know they’ve been disenrolled — and are likely uninsured — until their next medical appointment.

That scenario for a patient undergoing cancer treatment or dialysis would be “catastrophic,” Elizabeth Hertel, Michigan Department of Health and Human Services director, said in a statement this week, announcing the change.

Nicole Hudson, who as a special projects senior advisor with the department is overseeing the “redetermination” process for the state, agreed. Some of these people may end up in situations where (a sudden loss in coverage) could truly impact their ability to continue to receive care. This seems like a no-brainer to us,” she told Bridge Michigan Wednesday.

COVID suspended normal “churn” 

Michigan, like other states, is in the process of reviewing the eligibility of each person covered by its Medicaid programs — programs that grew from fewer than 2.5 million people just before the COVID pandemic to an unprecedented 3.2 million Michiganders by March this year, in part because of economic crises COVID created.

As the virus bore down in 2020, the Trump administration suspended the year-round process of checking beneficiaries’ continued eligibility for the program, a process that created a normal “churn” of people in and out of states’ Medicaid programs. The Biden administration then repeatedly extended that rule until earlier this year.

The state is staggering its review of all its Medicaid cases — also known as “Medicaid redetermination” or “unwinding” — over twelve months, or through May, 2024.

So far, deadlines have passed for more than 448,000 Michiganders who were to prove their continued eligibility for Medicaid by the end of July and August, according to the state’s "unwind" dashboard. 

Of those cases that have been reviewed in the first two months of the year-long process:

• More than 147,611 — or about one in three people — have lost coverage as of Monday, because they failed to submit proper paperwork.
• Medicaid coverage has been continued for nearly 270,666 Michiganders. Of those who still have coverage, the state “passively” renewed more than 154,423 because their income information was on file with the state from other sources, such as unemployment records. Another 116,243 people submitted paperwork, enabling the state to continue their benefits.
• Another 30,207 Michiganders have lost coverage after they were deemed ineligible for Medicaid because — among other reasons — they now are making too much money.
• In addition to the 448,807 Michiganders whose deadlines have passed in July and August, another 260,286 Michiganders are now under a one-month grace period that extended their deadlines from Aug. 31 to Sept. 30.

Michigan is among the first states, if not the first, to push back the renewal dates to May, 2024 for cancer patients and other beneficiaries who might otherwise lose their coverage and life-saving treatment for failing to prove their eligibility for the safety-net insurance program, Hudson said.

Those estimated 6,000 people would be reviewed for eligibility in May, she said.

Beneficiaries who lost coverage can still renew their policies, but only if they do so within 90 days of their last day of coverage.

Already, the health department took up an offer by the U.S. Centers for Medicare & Medicaid Services to offer a one-month grace period to those beneficiaries who had failed to meet their deadline for paperwork. It also began using other documentation, such as unemployment records from beneficiaries, to “passively” enroll beneficiaries.

Michigan is also allowing beneficiaries who lose coverage because of a lack of paperwork an extra 90 days to submit the proper documentation. So, beneficiaries who have lost coverage but submit paperwork within 90 days and meet the criteria for eligibility will have coverage reinstated.

All of these are reasonable steps to make sure Michiganders don’t lose coverage, said Sen. Curt VanderWall, a Republican from Ludington in west Michigan.

“I do believe it's our obligation as a state that we continue to do everything we possibly can to make sure people are covered,” he told Bridge Michigan Friday. “There does come a time when we've exhausted everything we can do until somebody comes in for medical treatment” and realizes they don’t have coverage.

Many of the more than 147,000 who have lost coverage likely don’t know that yet, VanderWall said “because none of them have actually gone in for any medical (care).

“When they do, they're going to find out that they’re not covered at all,” he said.