More than 350,000 Michiganders have lost Medicaid so far this year

• More than 350,000 Michiganders on Medicaid have lost coverage so far as the state conducts a year-long eligibility review 

• State Medicaid rolls grew to 3.2 million during the pandemic, when eligibility reviews were waived 

• State health officials say many people remain unaware of the need to once again file paperwork to prove they remain eligible 

As Michigan closes out the calendar year, it’s also nearing the half-way mark of a year-long process to review the eligibility of every person on Medicaid, the state’s safety-net insurance program.

The result so far: More than 350,000 Michiganders had lost coverage as of  Nov. 30. Most hadn’t submitted paperwork to prove they’re still eligible for benefits, with more than 61,000 others deemed ineligible, according to the most recent state data. 

Together, that means about 1 in 3 of the more than 991,000 Michiganders whose cases have been reviewed so far have lost coverage.

In worst cases, that could mean those men, women or children could show up for a doctor's appointment or emergency room visit, only to find out they no longer have insurance to cover their medical bills.

“I think we feel like we've done as much as we can, and we’ve tried to get the word out. We've tried to connect with beneficiaries,” said Nicole Hudson, who as a special projects senior advisor with the Michigan Department of Health and Human Services is overseeing the state’s review or “redetermination” process.

Under emergency federal rules during the COVID-19 pandemic, states had not been able to remove anyone from Medicaid rolls. That cut down on the annual “churn” in the programs, as people lost eligibility in a typical year and were replaced by those who gained it.

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Between March 2020, when COVID was first detected in Michigan, and May of this year, enrollment grew from just under 2.4 million people to more than 3.2 million — a 34 percent increase.

That steady increase, by the end of 2021, was already costing the state an additional $50 million each month compared to pre-pandemic, according to a budget briefing that year, written in anticipation of the “redetermination” process.

With the federal pandemic emergency ending earlier this year, Michigan and other states resumed Medicaid reviews to determine who still qualified. Consumer advocates had worried that many would lose coverage without knowing it. That has proven true, both in Michigan and across the nation.

A first batch of letters were mailed in March to people on state Medicaid rolls, alerting recipients they had three months to submit paperwork once their cases were up for renewal to avoid being disenrolled from Medicaid. The process would take up to a year, and the first beneficiaries under review had until June 30. That deadline was later extended to July 31, under special permission from the U.S. Centers for Medicare and Medicaid Services.

As of Nov. 30, the state had completed five months of its 12-month review. So far, it has reviewed the cases of 991,437 Michiganders as it makes its way through 3.2 million cases, according to the most recent state data. 

Of those:  

• 636,525 Michiganders (roughly two-thirds of those reviewed so far) kept their coverage. Within this group, 329,643 Michiganders were “passively” re-enrolled by the state, which used unemployment paperwork and other data to determine eligibility. Another 306,882 kept their coverage by submitting paperwork to prove eligibility.

• But 293,811 others lost coverage because they had not completed their paperwork. Most of them — 96 percent — haven’t submitted any paperwork at all.

• And another 61,101 lost coverage because they were no longer eligible — about half the time because they made too much income to continue to qualify for the program.

Nationally, at least 12.6 million Medicaid enrollees have been disenrolled as of December 7, based on the most current data from all 50 states and the District of Columbia, according to KFF, a San Francisco-based health research nonprofit that has been tracking the process across the nation.

Consumer advocates had been concerned that beneficiaries would lose coverage without knowing it — either because they missed letters notifying them of their obligation to reapply, or were overwhelmed by the process.

The  Whitmer administration has asked for several allowances, or “waivers,” from the U.S. Centers of Medicare and Medicaid to help residents remain covered. One of those waivers, for example, allows Michiganders on life-saving drugs to remain on Medicaid — no questions asked — until the year-long process is up.

Another allows Michiganders who have lost benefits an extra 90 days to renew coverage so that it’s retroactive to the day they lost it, said Hudson, of MDHHS.

“So that paperwork you find on your kitchen counter and you think ‘Oh my, I forgot to fill this out.’ You can still fill it out and send it in,” Hudson said.

Early next year, the state will launch an estimated $58,000 public awareness campaign, placing video ads at gas station pumps to alert consumers.

The good news? The state estimates 1 in 4 people who lost Medicaid coverage are now insured elsewhere — through a new employer or Medicare, for example. In addition, some who lost eligibility because their income was now too high to qualify may have found low- or no-cost coverage at www.healthcare.gov, the federal marketplace which uses tax credits to bring down the cost of premiums.

Bottom line: It’s not clear how many people might face higher medical bills because they lost Medicaid coverage through the review process, said Anne Scott, Health Center Operations Officer of the Michigan Primary Care Association, which represents a network of community centers throughout the state serving mostly uninsured patients or low-income patients on Medicaid.

But beneficiaries are likely in the process of re-enrolling or will be able to re-enroll when they find out they’ve lost coverage, Scott said.

“Many people walk through our office and say ‘I never received anything in the mail. ‘Do I have coverage?’ Or ‘Does my son have coverage?’” said Jeremy Lapidis, at the Washtenaw Health Project, a nonprofit that works with the county health department to help residents obtain health coverage. 

Even if they received letters, he said, consumers don’t always understand the bureaucratic language in them. 

The state “really did try to make it easier to understand, but it's just the amount of information” in the letters, said Tammy Frisbie, a health educator at MidMichigan Community Health Services, a community primary care clinic in Houghton Lake in northern Michigan. 

For the most part, awareness seems to be growing among patients about the state’s Medicaid review process, especially among patients whose chronic conditions require more medical appointments, she said.