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WERE 260,000 NEVADANS DROPPED FROM MEDICAID 'UNWINDING'? WHAT YOU NEED TO KNOW


ELIGIBLE BENEFICIARIES WHO WERE DISENROLLED FROM MEDICAID MUST RE-ENROLL WITHIN
60 DAYS TO GET CONTINUOUS BENEFITS AND AVOID A GAP IN COVERAGE.

Jason Hidalgo
Reno Gazette Journal


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The post-pandemic unwinding of Medicaid continues nationwide, removing millions
of people from the program after a moratorium that prohibited disenrollments
during COVID-19 expired.

The move marks a return to normalcy for Medicaid after a three-year period that
essentially froze the program’s ability to redetermine enrollees' eligibility
every year.

The unwinding also means many Nevadans were disenrolled from the program — just
under 260,000, according to the Kaiser Family Foundation’s KFF Medicaid
Enrollment and Unwinding Tracker.

Here’s everything you need to know about the ongoing redetermination process for
Medicaid and what you have to do if you find yourself disenrolled.




WHAT IS THE MEDICAID UNWINDING PROCESS?

The Medicaid unwinding refers to the end of the continuous enrollment policy
that started in March 2020.

The policy was enacted at the start of the COVID-19 pandemic to prevent people
on Medicaid and the Children’s Health Insurance Program or CHIP from losing
health coverage during the public health emergency.



“We were not allowed to terminate (Medicaid coverage) unless someone requested
it or passed away or moved out of state and let us know,” said Kelly Cantrelle,
deputy administrator of the Nevada Division of Welfare and Supportive Services.

“No one got shut off whether they were over income or not.”

The unwinding process started in June 2023, according to Cantrelle.




WHY ARE SO MANY PEOPLE BEING DISENROLLED BY THE MEDICAID UNWINDING PROCESS?

The unwinding is causing a large number of people to be disenrolled from
Medicaid due to several factors.

One is the sheer number of people who joined the program during the pandemic.

“Prior to the pandemic, 650,000 people were covered by Medicaid (in Nevada),”
Cantrelle said. “At the height of the pandemic, we had close to a million —
upwards of 980,000 people — so the pandemic drastically increased the numbers."



Add the fact that Medicaid was not allowed to disenroll people over a three-year
period and the result is a ballooning in the number of enrollees.

Nevada’s historical way of terminating enrollment also meant that many people,
including entire families, were automatically disenrolled if confirmations were
not sent on time. The state received a notice from the Centers for Medicare &
Medicaid Services last September that the way Nevada did redeterminations and
renewals for the unwinding needed to be changed.

“If (Medicaid coverage for) a household needed to be renewed, we would send a
packet to the household and if it didn’t comply, every person in the household
was terminated (from Medicaid),” Cantrelle said. 

The Centers for Medicare & Medicaid Services told the state that it needed to
redetermine eligibility on an individual basis instead.


SO JUST EXACTLY HOW MANY NEVADANS WERE DISENROLLED FROM MEDICAID DURING
UNWINDING?

A total of 257,800 enrollees in Nevada were disenrolled from Medicaid during the
unwinding process as of May 10, according to the KFF Medicaid Enrollment and
Unwinding Tracker. Meanwhile, 568,200 Nevadans had their coverage renewed.



The numbers from the Nevada Department of Welfare and Support Services are not
exactly the same as the KFF tracker, which uses a mix of state data and
information from the Centers for Medicare & Medicaid Services.

Cantrelle also noted that KFF totals still include people who have since been
readmitted to Medicaid or CHIP. After receiving the note from Medicaid that it
needed to verify eligibility individually, DWSS reinstated nearly 160,000 people
back into the program, for example.

Currently, just under 125,000 Nevadans remain disenrolled from Medicaid. Of that
number:

 * 77,789 were disenrolled for not responding or providing supporting
   documentation for their renewal.
 * 22,114  were disenrolled because they were enrolled in Medicaid in another
   state.
 * 24,459 were disenrolled because their income was too high.

Those who were making too much were referred to the Silver State Health
Insurance Exchange so they could apply for insurance from the marketplace
instead, according to Cantrelle.




HOW MANY NEVADANS DISENROLLED FROM MEDICAID HAVE SIGNED UP FOR INSURANCE ON THE
STATE EXCHANGE?

So far only a small number of people who were disenrolled from Medicaid have
signed up for insurance on the state exchange.

As of April 1, only 495 Nevadans referred to the state exchange by DWSS have
signed up for insurance, said Russell Cook, executive director of the state
exchange that runs Nevada Health Link.

Cook pointed out that the referrals from DWSS ultimately were cut down to about
12,300 because some individuals were referred multiple times. Not all of those
referrals also qualified for subsidies on the exchange to lower their monthly
fee, Cook added.

Although the enrollment rate has been low compared to the number of people who
have been referred, the good news is that the special enrollment period for
people who were referred to the exchange after being disenrolled from Medicaid
to sign up at the exchange runs through Sept.30.



The deadline provides enough time for people who lose Medicaid coverage during
the unwinding process.

“(We anticipate) another five months before the unwinding completes,” Cook said.
“We are looking at roughly through the end of September.”


WHAT SHOULD MEDICAID BENEFICIARIES DO IN RESPONSE TO THE UNWINDING?

If you’re on Medicaid and concerned about losing your benefits from the
unwinding process, here are some things you need to do:

Check your mail: Tens of thousands of Nevadans were disenrolled for failing to
respond and provide documentation for their renewal.

“They need to watch that mail for their renewal packet,” Cantrelle said. “If
something is requested from you, get it in as fast as you can.”

Respond within 60 days: If you were disenrolled for not responding or some other
reason but remain eligible for Medicaid, it is important that you reach out and
have your issue fixed within 60 days of losing your coverage.



“For those within that 60-day window, act now to avoid a gap in coverage,” Cook
said. “Not only will they avoid a gap in coverage but (re-enrolling) will be an
easier process to navigate.”

Re-enrolling within that 60-day period also means your Medicaid coverage will be
backdated to the first day you initially lost coverage, which is very helpful if
you have any claims at that time.

Otherwise, your coverage will start on the first day of the next month if you
re-enroll past the  60-day period.

Check Nevada Health Link: This advice is for people who are no longer eligible
for Medicaid. The health exchange can be a good option for affordable coverage,
especially for those who qualify for subsidies that can significantly lower your
monthly premiums.

You can visit the Nevada Health Link website or call 800-547-2927.


HOW DO I CONTACT THE NEVADA DIVISION OF WELFARE AND SUPPORTIVE SERVICES?

You can visit the DWSS’ Access Nevada online portal to apply for benefits
online.



To contact DWSS you can email welfare@dwss.nv.gov or call:

 * Northern Nevada: 775-684-7200
 * Southern Nevada: 702-486-1646


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