In April, May and June, a total of 63,988 West Virginians were kicked off their health care programs, as West Virginia and the rest of the country return to pre-pandemic eligibility requirements. (Getty Images)
In the first three months of reviewing who’s receiving state health care coverage, West Virginia dropped about 64,000 people from the rolls of the Medicaid and Children’s Health Insurance Program.
More than half of those removed lost their coverage for a procedural reason like not responding to a redetermination letter or not providing requested information.
According to Bureau for Medical Services’ data, in April, May and June, a total of 63,988 West Virginians were kicked off their health care programs, as West Virginia and the rest of the country return to pre-pandemic eligibility requirements.
During the COVID-19 public health emergency, states were prohibited from removing people from the programs in order to receive enhanced funding from the federal government.
The state’s Medicaid and CHIP enrollment swelled 30%, from 504,760 in March 2020 to 656,269 in December 2022, according to a news release earlier this year from the state Department of Health and Human Resources.
West Virginia started the process of assessing the eligibility of Medicaid and CHIP recipients beginning in April, as federal officials prepared to end the public health emergency status. The state anticipates the programs’ enrollment to drop by 10% to 15% overall.
Of the 63,988 people removed from the state’s health care programs, 36,505 were removed from the program for a procedural reason. Renewals were not completed for another 2,175. Another 25,308 were removed because they were deemed ineligible for the programs.
The state is sending out the same number of renewal letters each month to cut down on worker fatigue and accommodate staffing limitations, said Emily Hopta, interim communications director for DHHR.
Some of the people being removed from the programs only learn of the change when trying to access care, said Craig Robinson, executive director of Cabin Creek Health Systems, a federally qualified health center. Between 35% and 40% of Cabin Creek’s patients are Medicaid or CHIP recipients, he said.
Sometimes losing Medicaid or CHIP coverage is downplayed because people can reapply and get the benefit again eventually, Robinson said, but it can create health problems.
“It can be a real disruption of care [when] people lose the benefit,” he said. “They can’t buy the drug they need that month, or they can’t receive another kind of treatment, or they’re in the midst of a cancer treatment regimen — it can be very serious.”
A condition like hypertension, for example, can cause long-term damage if left unmedicated during a gap in coverage, he said.
The state expects the early months of the review process will see more disenrollments than later months “due to prioritization of certain renewals and lack of awareness of the process,” Hopta said.
Over the first three months, a total of about 146,000 people were up for renewal and about 81,949 remained enrolled in the programs, according to state data.
Robinson said Cabin Creek was able to support patients through the process. “We’re able to help people with applications,” he said. “We have a sliding-fee scale, so people still get care if they don’t have coverage. That’s our job. That’s our mission. But that’s not true for Medicaid everywhere.”
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The federal government allowed states a number of waivers in order to go through an “unprecedented volume of renewals and application determinations on a timely basis.”
States were allowed to enroll people based on their eligibility for other safety-net programs and to partner with managed care organizations to update recipients’ contact information.
According to the federal government, as of July 7, West Virginia had been approved for three of 17 possible waivers.
The state’s plan to alert people of the changes included social media posts and posters, emails and robocalls. A third robocall is going out this month to people who have lost coverage because they didn’t respond to a renewal notice or because they responded but didn’t provide all of the requested information.
The state also extended to 90 days the deadline for a renewal to be returned and is tracking the number of people who regain coverage after being removed for initially not returning a renewal, Hopta said in an email.
“West Virginia does not have information on why individuals do not respond to renewal notifications, but with the currently low unemployment rates, the hope is that many have obtained employer-based insurance,” she said.
According to data from KFF Health News, 57.7% of private sector establishments in West Virginia offered health insurance to employees as of 2021.
The state encourages Medicaid and CHIP recipients to watch their mailbox for a renewal letter from the DHHR and to complete it if they receive one.
Medicaid and CHIP recipients can also contact the DHHR to make sure their contact information is up to date by logging into their WV PATH account, emailing [email protected] or calling 1-877-716-1212.
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