Opinion: Cleaning up safety nets, preserving dollars for people in need, is welcome

Elizabeth Hovde states that if we experience another pandemic, national leaders should resist a continuous-coverage requirement for Medicaid

Elizabeth Hovde
Washington Policy Center

One of the biggest cost-savers for taxpayers, hospitals and health care consumers is available right now: States are finally allowed to disenroll people no longer eligible for Medicaid. Those Medicaid recipients cost state and federal taxpayers unnecessarily and take resources away from people in need. They also burden hospitals and doctors who receive insufficient reimbursement for Medicaid patients in their care.

This cost-saver is something that should be seen with hope and relief, not the dread and fear coming from various advocacy groups and the Centers for Medicare and Medicaid Services (CMS).

President Joe Biden’s administration is contributing to the fear-mongering, criticizing states for doing the responsible thing and cleaning up their welfare rolls expeditiously. The administration is urging states to slow down their redetermination processes.

But redeterminations are sorely needed after the federal government required states to keep clients on the rolls during the pandemic years whether or not they needed coverage. (That requirement was agreed to by states if they wanted extra money from the federal government, and those extra federal dollars are going away with the end of the public health emergency.) If states are ready to do the redetermination work, the administration should be encouraging them along.

Medicaid swelled nationally by more than 23 million people during pandemic years and in Washington state by 506,400 recipients, the Kaiser Family Foundation reports. Medicaid in Washington, also known as Apple Health, is about 2.2 million people strong. That means one in four Washingtonians are on Medicaid, explained the state’s Medicaid director, Dr. Charissa Fontinos, on Inside Olympia.

Still, Washington state isn’t moving efficiently with disenrollment. Rather, it is choosing to use all 12 months allowed to right the welfare rolls that bloated in the pandemic years, despite saying it is ready and able to accomplish the task. Some people will not even get a renewal notice until late 2023 or early 2024.

That’s disappointing. The state should be chomping at the bit to lighten the weight in our state’s safety net, reserving monetary help for the most vulnerable.

Many people needed the taxpayer-provided safety net when businesses were shuttered and jobs were lost in COVID-19 times. But as workers regained employment income and access to employment-provided health insurance, it meant a lot of people were no longer in need or became dually insured. Those people are the first that states are looking to drop and rightly so.

The Associated Press reported in mid-June that about 1.5 million people have been removed from Medicaid in more than two dozen states that started the process of post-pandemic disenrollment in April or May. Daniel Tsai, a top federal Medicaid official expressed concern about that, telling reporters, “Pushing through things and rushing it will lead to eligible people — kids and families — losing coverage for some period of time.”

Hold your hankies. Many people are being disenrolled for not responding to the forms provided simply because Medicaid is no longer a need for them. Let’s not create a crisis. People on Medicaid throughout the country and in Washington state are notified several times and in different ways that they need to fill out forms to stay on Medicaid if they are eligible. And even if they ignore all the paperwork they are sent and are in need, they will be financially cared for retroactively for 90 days if they receive care. Generous stopgaps have been built into the disenrollment process.

Returning Medicaid to a true taxpayer-financed safety net is good news. And if we experience another pandemic, national leaders should resist a continuous-coverage requirement for Medicaid. It was not needed in many cases but cost taxpayers a lot of money and increased government dependency.

* In Washington state, help is available to Medicaid clients through Apple Health. The state even helps people find other taxpayer-subsidized health care to ensure their health care needs are being met.

Elizabeth Hovde is a policy analyst and the director of the Centers for Health Care and Worker Rights at the Washington Policy Center. She is a Clark County resident.