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Up to 400,000 Virginians could lose Medicaid coverage

Ambulance by health facility
An ambulance pulls up to an emergency room at the Medical College of Virginia. (Photo: Crixell Matthews/VPM News)

An upcoming review of Medicaid eligibility could result in between 280,000 and 400,000 Virginians losing their coverage, a state official told lawmakers on Tuesday.

The change is connected to a major expansion of the program over the past two years.

Beginning in March 2020, the federal government offered states extra funding if they paused their annual reviews, which determine whether members still are eligible. In exchange for not kicking anyone off the program, Virginia took in more than $1 billion in additional federal funding and added 500,000 people to its rolls — a number that continues to grow.

But state officials expect the pause to expire as early as September if the federal pandemic health emergency runs out without renewal. That means the more than 2 million Virginians currently enrolled in Medicaid will have to submit information to verify they’re still eligible.

Some of those people are likely to have gotten health insurance through a new job; others might now make too much money to qualify. But state officials and advocates are working to target a third group: people who are still eligible but are hard to reach or unaware of the review.

Debbie Oswalt, executive director of the Virginia Health Care Foundation, said many people who’d enrolled in Medicaid since lawmakers expanded eligibility in 2018 might not know they need to renew because of the disruptions caused by the pandemic.

“If they became eligible in 2019, which is when the program started, very few of them would likely have had to undergo any kind of renewal process,” she said.

Ads are already running throughout Virginia to get the word out, according to Sarah Hatton, deputy director of administration at the Virginia Department of Medical Assistance Services. The state also is bringing on 100 contract workers to help local officials handle the process, Hatton told the Senate Finance committee on Tuesday.

Chart showing Virginia medicaid enrollment stats
Demographic data on Medicaid members in Virginia. (Department of Medical Assistance Services)

Hatton said officials would work with people who might lose coverage to get it elsewhere, including the federal marketplace.

“I think it's important to note that not all of these will be bad losses,” Hatton said. “Some of these individuals may have obtained employment and may have employer-sponsored insurance.”

Oswalt applauded the state’s efforts but said it will be a struggle to make sure everyone who is eligible maintains their coverage.

“Even with those best efforts, it's likely that people who are eligible will not hear of it for one reason or another and fall through the cracks,” she said. “They won’t have coverage when they need it.”

How to get help with Medicaid

For now, Medicaid members should not expect any changes to their coverage because it’s not clear yet when the pandemic health emergency will expire. 

In the meantime, state officials are asking Medicaid members to make sure all of their contact information is up to date the following ways:

  • Online at commonhelp.virginia.gov
  • By calling Cover Virginia at 1-855-242-8282
  • By calling the local Department of Social Services

Once the pandemic health emergency ends, state officials will begin reaching out to Medicaid members over the span of 12 months. According to the Cover Virginia’s website, if a member no longer qualifies for health coverage from Virginia Medicaid, they will get:

  • Notice of when the Medicaid coverage will end
  • Information on how to file an appeal if the member thinks the decision was incorrect
  • A referral to the federal marketplace and information about buying other health-care coverage.

Medicaid is still accepting new members. People can determine if they’re eligible to enroll here.