If you are a Medicaid recipient, you and millions of others may be at risk of losing Medicaid in 2023 due to coming changes in the 2023 Omnibus Appropriations Bill this spring.
Medicaid is a national health insurance program for low-income individuals, children, pregnant people, elderly people, and those with disabilities. It is usually provided to recipients at no or minimal costs. While it is a national program funded on both the federal and state levels, eligibility is determined on the state level, and each state sets its own guidelines. This is critical, as the new Omnibus Appropriations Bill allows states to begin Medicaid redetermination, or to start terminating benefits for those no longer within state guidelines for Medicaid coverage starting in April.
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What is the 2023 Omnibus Appropriations Bill?
The 2023 Omnibus Appropriations Bill is a $1.7 trillion spending package approved by President Biden on December 29, 2022, for the 2023 fiscal year. It combines all spending bills for 2023 into one bill and includes budgets and funding for items such as natural disaster relief, education, and healthcare.
The Bill includes funding for many state programs, such as SNAP (Supplemental Nutrition Assistance Program), CHIP (Children’s Health Insurance Plan), and WIC (a nutrition program for Women, Infants, and Children) — as well as funding for state Medicaid benefits. However, the Bill also includes legislation that would allow states to begin terminating Medicaid benefits on April 1, 2023 for those who no longer qualify.
Why and How Are Medicaid Recipients at Risk Due to Medicaid Redetermination?
Previously, individuals had to meet criteria set by their state, which was typically based on income, and apply to receive Medicaid benefits. They usually had to reapply annually to remain eligible.
During the COVID pandemic, however, Congress prohibited states from removing individuals from Medicaid even if they no longer qualified due to changes in income. Now, the 2023 Omnibus Appropriations Bill will remove the ban placed by Congress; this means individuals must return to meeting eligibility criteria set by their state to maintain their Medicaid coverage during this Medicaid redetermination period.
This can begin as early as April 1, 2023, after which Americans may see themselves dropped by Medicaid, leaving them without health coverage.
What These Changes Mean For You
If you or your family currently receives Medicaid, make sure to reach out to your state office or local agency immediately to ask if and when your coverage ends. Keep in mind that you may need to apply again to prove that you meet your state’s eligibility criteria to continue receiving benefits. Reapplying as soon as possible can help reduce the risk of a gap in your health insurance coverage, and will ensure Medicaid and CHIP maintain the most up-to-date information as possible.
Many states allow applicants to complete forms online, though you may also submit your application at a local Medicaid office.
If you find that you are no longer eligible for Medicaid, your coverage could end as soon as April 1, 2023. However, the Centers for Medicare and Medicaid Services announced that it will open a special enrollment period for those affected by Medicaid redetermination. This special enrollment period will be called the “Unwinding SEP” and will run from March 31, 2023 through July 31, 2024.
The usual open enrollment period for Affordable Care Act-compliant health insurance plans ended in January for the 2023 coverage year and the next open enrollment period is not set to begin again until November. For this reason, it is important to make sure that you enroll in an ACA plan during this special enrollment period if you are losing your Medicaid coverage. This will help you reduce the potential gap in your health coverage.
How Many People Will Be Impacted by The 2023 Omnibus Appropriations Bill?
After April 1, 2023, approximately 5.3 to 14.2 million people will lose Medicaid coverage either from loss of eligibility or neglecting to reapply. The majority of those impacted will be those who benefitted from the continuous enrollment provision, which had allowed individuals to keep their Medicaid coverage without needing to redetermine their eligibility and reapply every year. An estimated 6.8 million of those disenrolled are likely to still be eligible for Medicaid coverage, but need to apply anew for their coverage.
Note that recipients who meet state guidelines and have recently reapplied may see no change in their coverage.