Medicaid is the largest payer for health care in the US, covering greater than 90 million people—that’s one in 4 Americans. Throughout the COVID-19 pandemic, an official federal public health emergency (PHE) was declared on March 13, 2020 and was renewed thirteen times in the next years over the course of the continuing pandemic. 

The PHE stopped Medicaid renewal processes, essentially allowing Americans who would not qualify for Medicaid outside of a PHE to proceed receiving care through their state’s Medicaid program. 

Nonetheless, the PHE officially ended on May 11, 2023. What does this mean for individuals who have been receiving Medicaid this whole time—especially individuals with diabetes?

What’s Medicaid? 

Within the land of privatized medical insurance, Medicaid is a beacon of hope for a lot of and a sturdy social safety net that keeps hundreds of thousands of individuals alive. Most people covered by Medicaid are low-income populations—this includes children, seniors, pregnant individuals and other people with disabilities like diabetes. 

Medicaid works like all other insurance plan, except there are not any monthly premiums, no yearly deductibles and there are rarely co-payments for medicines like insulin or emergency room visits. 

Medicaid is jointly funded and administered in partnership between the federal government and states. So each state’s Medicaid program might be run completely in a different way from the subsequent, and in addition they can have different eligibility requirements. 

Under the 2010 Patient Protection and Inexpensive Care Act, 39 states (plus the District of Columbia) have expanded and implemented income eligibility for people to qualify for Medicaid, which varies by state and is a percentage of the federal poverty level (FPL). 

Income eligibility might be determined as often as monthly, so there are a number of individuals who typically fall off and back on, especially if their income is variable—except throughout the pandemic. Everyone was in a position to keep their insurance for the past 3 plus years.

Tens of millions of individuals have lost coverage

The official declaration of the top of the PHE triggered a series of events, allowing states to restart their Medicaid renewal processes—including reinstating eligibility requirements, like taxable income and tax-filing relationships. 

This has led to hundreds of thousands of individuals losing their Medicaid coverage.

States are working at different paces, but all are disenrolling patients who’ve had coverage for the past three years. Texas has disenrolled a shocking 82 percent of its Medicaid recipients, while states like Wyoming have only disenrolled 8 percent. 

Over 3.7 million people have lost their medical insurance coverage, with over half 1,000,000 of those people living in Texas alone—in only the primary month of disenrollment.

The Kaiser Family Foundation (KFF) predicts that as many as 24 million people could lose their coverage over the subsequent few months. A lot of these people (a whopping 74 percent), are losing coverage simply as a result of paperwork errors or slow processing times of their renewal paperwork. 

Losing medical insurance might be devastating for somebody living with a chronic illness like diabetes. It signifies that whenever you show up on the pharmacy counter to get your insulin, it’s not covered. It signifies that shipments of continuous glucose monitor (CGM) supplies to your house every month abruptly stop. 

Losing medical insurance with no backup plan means you’ll be able to not see your endocrinologist, or any doctor in any respect, for that matter. For people living with diabetes, it spells disaster for many and certain death for some. 

What to do for those who’ve lost Medicaid coverage 

If you happen to’re one in every of the hundreds of thousands of people that have recently lost Medicaid don’t panic. There are alternatives to make sure continuity of care on your diabetes management. 

Since losing Medicaid coverage is a “qualifying event”, you’ll be able to seek latest medical insurance at any time and also you shouldn’t have to attend for open enrollment to start on November 1st. 

The next are ways to make sure you’ll be able to get medical insurance quickly:

• Ask your employer in the event that they offer insurance (in the event that they do, join ASAP, and coverage will normally begin on the primary of the next month).
• Buy your personal medical insurance on the marketplace (which offers heavy subsidies for middle-income people).
• If you happen to think you’ve been wrongly disenrolled, you’ll be able to re-apply on your state’s Medicaid program to see for those who are still eligible.
• If you happen to’re under the age of 26 and recently lost Medicaid coverage, you’ll be able to access medical insurance in your parent’s medical insurance plans. 
• Moreover, for those who’re married and your spouse has medical insurance through their employer, you qualify for coverage under their insurance, too. Check together with your spouse’s employer for eligibility requirements (proof of domestic partnership or marriage, etc.) and costs related to coverage, which could also be higher than for those who carried your personal insurance.
• If you happen to need assistance affording your insulin, visit getinsulin.org for resources on accessing insulin quickly.

Whilst you wait to regain insurance coverage, take a look at our resources for getting assistance together with your diabetes management supplies.