Thousands of Idahoans removed from Medicaid through the opt-out process are coming back – Idaho Capital Sun

About 13,000 Idahoans removed from Medicaid after failing to respond to state request for information after pandemic-era protections expire are back in the program, an official announced Tuesday.

Idaho health officials in August done reviewing the eligibility of 153,000 people they flagged as likely ineligible for Medicaid, either because they did not respond to the state’s request for information or because their information indicated they were ineligible.

Idaho removed 121,000 people from that group from the Medicaid rolls, but state officials only proved that about 45,000 people were actually ineligible for Medicaid. Another 77,000 people were removed because they did not respond to state requests for information, said Idaho Department of Health and Human Services Deputy Director Jennifer Palagi.

Who qualifies for Medicaid enrollment in Idaho?

Anyone who is eligible for Idaho Medicaid can enroll at any time. Idaho Medicaid is open to single adults earning $1,677 each month, or a two-member household earning $2,268 per month. Program income guidelines are available for different household sizes online. Idaho Medicaids income limits for children are higher.

Palagi told the Ministry of Health and Social Protection board on Tuesday that state officials expect more people who were removed to return to the program, a process commonly called opt-out. People losing Medicaid coverage and then returning to the program happen normally, she said. But experts expected it to happen more often as states begin to review Medicaid eligibility for the first time since the pandemic.

We expect a larger outflow, Palagi said.

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Anyone who lost Medicaid starting in April 2023 can enroll in insurance policies at Your Health Idaho, the health insurance exchange says, until Nov. 30 through what officials are calling a special open enrollment period. Insurance plans through Your Health Idaho they are open to everyone to register for policies valid in 2024 by December 15.

By the end of September, 31% of Idahoans who had been removed from Medicaid received coverage through Your Health Idaho. But officials said they don’t know where everyone removed from Medicaid goes for health insurance.

Medicaid rollouts were occurring in states across the US

Nationally, since states began assessing eligibility for people on Medicaid, five million people have been removed from the program, including two million children, according to Georgetown University Center for Children and Families.

Idaho has the second-highest Medicaid opt-out rate of any state, at 64%, second only to Texas, according to KFF. Idaho also had the third-highest rate of procedural exclusions, when officials remove people from Medicaid for failing to respond to a state request for information, KFF reported.

About 48% of the people removed from Medicaid in Idaho were children, the fourth highest rate of children removed, KFF reports.

Idaho started to remove people from Medicaid earlier and more targeted than other countries.

Idaho began removing people from Medicaid in April, when pandemic-era protections for Medicaid enrollees were lifted. Only four states began removing people so early.

Idaho officials also focused on removing people from Medicaid who they thought were likely ineligible. Only 21 states prioritized at least some renewals for people who were likely ineligible.

State officials previously told the Idaho Capital Sun that the rate of people removed for not responding to the state will drop after the state completes its review of people who are likely ineligible for Medicaid.

Idaho Medicaid serves about 450,000 people, the Idaho Department of Health and Human Services said in its budget request filed in September.


What is a Medicaid exclusion?

Federal law during the COVID-19 pandemic prevented states from removing people from Medicaid. States can now remove people who no longer qualify. But Idaho hasn’t stopped processing renewals for people on Medicaid during the pandemic. Instead of removing ineligibles from the program during the renewal process, state officials marked them as likely to be removed.

The state health department flagged about 153,000 people at the time either because they did not respond to states’ requests for their information, or their records showed they were ineligible for Medicaid. Those people became what Idaho called the Medicaid Protection population.

Officials stress that if you’ve been removed from Medicaid but are still eligible or become eligible, you can reapply at any time. Idaho will also reinstate Medicaid coverage for people removed from Medicaid who completed part of their application to avoid coverage gaps after removal if people reapply within 90 days of removal.

To make sure you know when the Idaho Department of Health and Human Services is evaluating your Medicaid eligibility, update your address and contact information with the department. Go online at idalink.idaho.govor contact [email protected] or call 877-456-1233.

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