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Bad paperwork is driving most of the turnover on Utah’s Medicaid rolls

Utah's Department of Health and Human Services offices at the Martha Hughes Cannon building in Salt Lake City, June 5, 2023.
Jim Hill
Utah's Department of Health and Human Services offices at the Martha Hughes Cannon building in Salt Lake City, June 5, 2023.

More than 600,000 Americans have lost Medicaid coverage since pandemic protections expired on April 1. States are re-evaluating their Medicaid rolls because Congress ended pandemic protections with the budget bill the president signed last December.

In Utah, the biggest driver of lost coverage has been procedural reasons, like bad paperwork or missed contacts. Since the protections ended, almost 20,000 Utahns have lost coverage for that reason.

KFF Health News reporter Hannah Recht compiled data from 14 states — including Utah — and found that in many cases, people lost coverage not because they aren't eligible anymore, but because they haven’t filled out the paperwork.

“There is a massive scope of redeterminations that's happening all at once,” she said. “And people are really being caught unaware.”

At the beginning of the COVID-19 pandemic, state Medicaid agencies were required to continue coverage for all people enrolled, even if their eligibility changed. After those protections ended in April, people had to readjust to once again applying for coverage.

“After three years of states not having to redetermine who's still eligible for Medicaid, there are millions of people who are covered by the program who've never been through this process, or they've moved and haven't updated their addresses with the states,” Recht said.

According to the Utah Department of Health and Human Services, notices to renew are sent out via email and traditional mail to the over half-million Utahns covered by Medicaid. If a person forgets, there’s still a 90-day window to restore their coverage.

On June 5, the department disclosed that a “mailing error” resulted in Medicaid information for an estimated 5,800 Utahns being mistakenly put in incorrect envelopes and sent to the wrong addresses. The agency said new letters would be sent out over the next two weeks.

That urgency is being felt in Utah.

“We are seeing a very increased call volume,” said Utah Health Policy Project Executive Director Matt Slonaker. “I got word just last week that our folks that can help people enroll in the marketplace have full calendars two weeks out. That's pretty unprecedented.”

It’s not always people just forgetting to renew; the Medicaid application process can take weeks to complete and requires a number of documents not always easily accessible.

A Medicaid application is very lengthy, over 20 pages long,” Slonaker said. “It requests information that oftentimes takes asking an employer to provide payroll forms. It requires you to sort of sit for a lengthy period of time when you're busy trying to get work done, take care of children. It's hard to put that time together.”

If a person believes they have lost coverage incorrectly, the state’s Department of Health and Human Services invites them to reapply. There’s also an appeals process.

“It’s really important for people to know that if you are losing Medicaid coverage and you think you're still eligible, you can contact your state and appeal that decision and ask for more time and they can still cover you while they're sorting it out,” said Recht.

For Slonaker, the organization expects to handle a record number of Medicaid cases in 2023.

“I think 10,000 plus is going to be a safe number for 2023,” he said. “Historically, we’ve averaged anywhere from 6 to 7,000. But this is going to be a banner year for Medicaid enrollment. … We need to make sure that all those folks who are being redetermined or losing their coverage end up in some type of health insurance so they can protect their families.”

The Medicaid unwinding process in Utah ends April 30, 2024.

Sean is KUER’s politics reporter.
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