More than 300,000 Oklahomans have disenrolled from Medicaid as recess looms

The Oklahoma Health Care Authority is nearing the end of a nine-month period in which it removed hundreds of thousands of Oklahomans from Medicaid due to the expiration of federal pandemic health care protections.

The state agency that oversees Oklahoma’s Medicaid program, known as SoonerCare, will complete its Medicaid unwinding process by Dec. 31.

This process requires all states to resume normal Medicaid enrollment and eligibility processes, ensuring that only residents who qualify are eligible to receive benefits. This comes after rolling back federal health care protections that had been in place for nearly three years.

During the COVID-19 pandemic, a federal public health emergency prevented states from removing people from their Medicaid rolls even if they were no longer eligible for health benefits for low-income residents. Under normal circumstances, health care authorities routinely disenroll Medicaid recipients who are no longer eligible because of their income or other reasons.

As of November 30, more than 307,000 Oklahomans had been disenrolled from the health care benefits program. The agency estimates another 29,769 Oklahomans will be disenrolled in December.

To qualify for Medicaid, an individual must earn less than $20,124 annually and a family of four must earn less than $41,400.

Emily Long, a spokeswoman for the health care authority, said about 173,183 Oklahomans lost Medicaid coverage due to procedural denials, including one that did not complete the necessary paperwork to maintain their coverage.

Oklahoma offers real-time Medicaid application processing. If someone discovers they have lost coverage, they can reapply and immediately know if they are still eligible for Medicaid and begin accessing health care coverage the same day, Long said. Said.

The health care authority also backdates coverage by 90 days. If someone regains coverage, Medicaid will cover claims up to about three months old, he said.

The Health Coalition for the Uninsured, which helps uninsured people get care at more than 90 free clinics across the state, said those facilities are seeing an increase in the number of patients as more people lose Medicaid coverage. Have been.

“We’re seeing an increase in the number of referrals for people who need health care because so many people are missing out,” said Jeanien Yanish Jones, executive director of the group.

She said the clinics are also seeing more people coming to the clinics with more serious health concerns, who may be delaying care due to lack of health insurance.

The health care authority structured its unwinding process to ensure that the state’s most vulnerable residents who no longer qualify for Medicaid maintain their coverage for as long as possible.

The agency began the unwinding process in May by disenrolling ineligible recipients who had not used their Medicaid benefits, people who already had other health insurance and adults without young children.

As the unwinding process begins to wind down, the agency has begun disenrolling Medicaid recipients with chronic conditions, those with young children and those undergoing medical treatment.

As we approach the end of this nine-month period, we are most vulnerable and those who are using services the most, said Yanish Jones. This is a really important part of the unwinding process because there was very little impact in the first few months because there were people who probably never filed a claim. Some people may not even know they were on SoonerCare

He said he hopes that as people lose their coverage, they are taking steps to reapply for Medicaid or get health insurance through their employer, the federal marketplace or elsewhere.

Yanish Jones said it usually takes about nine to 12 months for someone to get health coverage back after losing Medicaid benefits.

Historically, Oklahoma has been one of the worst states in terms of the rate of its uninsured residents, although the number of uninsured Oklahomans has decreased significantly after the state expanded Medicaid in 2021. About 12% of the state’s population, or 463,300 Oklahomans, were uninsured as of last year. , according to KFF, a health care policy group.

The Oklahoma Department of Human Services, which oversees Medicaid services for the state’s elderly, blind and disabled populations, will continue its open process through March.

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