By Mahlon Meyer
NORTHWEST ASIAN WEEKLY
For those with private insurance or Medicare, the end of the COVID-19 Public Health Emergency (PHE) on May 11 should pass almost unobserved. But for those with Medicaid coverage, some caution should be taken, especially so that they won’t miss their notification to re-enroll, whether it comes by mail or by phone.
And especially for those who may have difficulty responding to the notification, whether because of language difficulties, because they’ve moved, or because their health condition makes it extremely difficult to take notice, the end of the PHE could be challenging.
To reduce the impacts of the change, the Department of Health as well as local organizations have been and will continue to make efforts in informing people about re-enrollment.
In the state of Washington, roughly 300,000 clients will be affected as the Washington State Health Care Authority (HCA) seeks to redetermine if they are still eligible for coverage.
“From a health equity and outcomes perspective, one major impact for the community is Medicaid enrollment,” said Josh Liao, the associate chair for Health Systems, faculty in the Schools of Medicine and Public Health, and the enterprise medical director of Payment Strategy at the University of Washington.
Benefits of the PHE
The COVID-19 PHE, initiated in 2020, automatically re-enrolled individuals in Medicaid, which is the government insurance for those in poverty, according to state standards.
According to advocates and researchers, many benefits accrued as a result of the program. For instance, 12.6% of Washingtonians had no medical coverage as of May 2020. A little over a year later, that figure dropped to 5.2%, according to a state tally.
Other benefits were unforeseen—and highly impactful. Emily Brown, an assistant professor of Pediatrics at the University of Washington School of Medicine, in a highly respected study, found that the expansion of Medicaid reduced the neglect of children.
“Our study provides another example of a social policy, in this case Medicaid expansion, being associated with reduced child maltreatment, specifically child neglect rates,” said Brown.
How do you keep Medicaid coverage?
Losing coverage could result from multiple factors. If someone moves, for instance, that person may not receive a notification letter. In 2020, according to Liao, 10% of Medicaid enrollees nationwide moved, which translates into roughly the same figure for Washington state. Missing the notification, as a result, and not responding or providing requested information, can lead to an individual not getting coverage. Another potential impediment is language, said Liao. Luckily, Washington state is among a limited number of states that provides important materials, forms, and frequently asked questions in multiple languages.
Changes in one’s status could also make an individual ineligible for future coverage. While the main disqualifier would be income change, individuals must also report other changes when they occur, said Liao, including marital status, residential address, immigration and citizen status, or pregnancy.
Therefore, to keep Medicaid coverage, it is important for Medicaid recipients to stay informed by following trusted information sources, checking for any email or mail about Medicaid, and updating their information in a timely manner. Individuals must make sure they are aware of their re-enrollment deadline and start looking out for the notification in the month prior to that date. Otherwise, they may not be able to respond in time. People can learn more about staying informed and about all of the changes by visiting the Apple Health website.
More re-enrollment instructions and information can be found in the following online PDFs:
- English: https://www.hca.wa.gov/assets/free-or-low-cost/19-053-renew-apple-health-coverage.pdf
- Chinese: https://www.hca.wa.gov/assets/19-053-renew-apple-health-coverage-CH.pdf
Notifications are sent in the month prior to coverage ending
It is important to note that clients receiving Medicaid—or Apple Health, as it is referred to in Washington state—are not losing their coverage on April 1.
According to the HCA, individuals will receive a renewal notice sometime over the next 12 months.
However, the date the renewal notice is sent out depends on the date the individual’s coverage is set to expire.
Individuals will receive a renewal notice in the month before their coverage is set to end, according to the HCA.
Looking out for those who may fall through the cracks
Michael Byun, the executive director of Asian Counseling and Referral Services (ACRS), said that his organization’s caseworkers are proactively contacting clients.
“The key thing we’re concerned about is the impact of the end of the PHE, the impact on those individuals who during the height of the pandemic were in precarious situations,” he said.
Financial precarity and extreme medical situations both could make it harder for an individual to respond to a notification of redetermination.
In addition, individuals with language access issues might also miss notifications.
Case managers at ACRS are reminding clients by phone and face to face not only about the impending notifications, but to bring any letter they don’t understand to their case manager.
“But there are always individuals who fall through the cracks,” he said. “It is our duty as a community-based organization and as a society to ensure each person can get through this transition.”
ACRS is one of many other community-based organizations that are working to help their members have a smoother transition and get the coverage they need. Individuals should not be afraid to reach out and seek help from their local organizations. The Apple Health website also has important documents about Medicaid translated to multiple language that people can access through this link.
Medicare and private insurance not impacted
For those covered by Medicare or private insurance, there is no impact.
At Luke’s Health Mart, in the heart of the Chinatown-International District, senior citizens waited calmly for prescriptions. The pharmacist, who gave his last name as Chen, said the clients he serves for the most part have social security and Medicare, and thus may not even know the PHE is ending.
Furthermore, although the mask mandate has been lifted in Washington state and it is now up to local organizations and tribal governments to enforce mask rules, Chen said that his clients were so accustomed to wearing masks, any changes in that direction would not impact them at all.
An administrator at the St. Paul’s Clinic, also in the neighborhood, who declined to give her name since she was not authorized to speak to the press, said her clients all had effective insurance or paid privately.
She said she had not even heard of the PHE.
Mahlon can be reached at firstname.lastname@example.org.
Made possible in part by the Washington State Department of Health through a grant from the Centers for Disease Control and Prevention. This information does not necessarily reflect the official policies of the Washington State Department of Health or the Department of Health and Human Services.
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