Some 40 million children currently enrolled in Medicaid or CHIP (Children’s Health Insurance Program) nationwide are at risk of losing their health insurance once the COVID-19 Public Health Emergency (PHE) expires. Declared in early 2020, the PHE provides a federal guarantee of continuous Medicaid coverage during the pandemic.
Initially set to expire on July 15, the Biden administration last week extended the declaration to October 15. a provision included in the Families First Coronavirus Relief Act approved in March 2020.
Now states are once again required to check eligibility for everyone enrolled in Medicaid, including kids.
According to the California Department of Health Care Services (DHCS) of the 5.7 million children covered by Medi-Cal in the state, between 800,000 to 1.2 million kids will lose their coverage.
“This will disproportionately impact children of color, who are more likely to rely on Medicaid for coverage,” said Mayra Alvarez, president of The Children’s Partnership during a briefing hosted by Ethnic Media Services on May 20.
“75% of the more than five million kids covered are kids of color who will miss out on critical preventive and primary care services that are especially important for our youngest children.”
During the PHE, families could stay enrolled in health care coverage through Medicaid without additional administrative renewals or having to prove their eligibility. There were flexibilities with COVID testing and treatments, vaccinations, telehealth access and other public programs.
“Children still need to catch up on their well child visits that were not only missed during this pandemic, but that are particularly important during the first few years of a child’s life when 90% of her brain development occurs”, said Alvarez.
For Georgina Maldonado, Executive Director of the Community Health Initiative of Orange County these changes are part of the systemic barriers “we have been fighting historically as a community.”
“If this is working, why bring back the barrier that has prevented us historically, from obtaining healthcare coverage?”, Maldonado said. “What we’re facing is that most parents have never navigated the manage health care system in our county and our state, they have never had benefits in the past. Enrollment and disenrollment is vital.”
Governor of California, Gavin Newsom has launched a multibillion-dollar initiative to prioritize child and youth mental health, including early care and learning investments. Thanks to grassroots organizations like Maldonado’s, undocumented children are now eligible for full MediCal scope. In spite of all these efforts, less than half of uninsured children who are eligible for Medicaid, are enrolled in the program.
That is why the Children’s Partnership has been working with Assemblymember Blanca Rubio (D) on AB 2402, a piece of legislation guaranteeing multi-year continuous Medi-Cal coverage for 0- to 5-year-olds. The Senate has included this bill in their budget priorities that are currently under negotiations with the Assembly.
“The opposition to the bill comes from people who believe poverty is a personal responsibility, and that there should be steps for people to prove their eligibility for these programs,” added Alvarez. “Some people are concerned with the cost of programs more broadly.”
On a federal level, the expiration of the PHE will cause that 80 million people, including 37 million children, will have their health insurance checked, said Joan Alker, healthcare research professor and Executive Director at the Georgetown University Center for Children and Families.
“Families could lose coverage as they’re not going to be eligible if their income has gone up a little bit. Adults may be eligible for subsidized marketplace coverage and children may be eligible for CHIP,” explained Alker. “In some states like California, Medicaid and CHIP are all in one program now. But in Texas, Georgia and Florida, they’re not.”
States have 12 months to check everybody’s eligibility once the PHE is expired. Alker is hopeful that with the prediction of a fall and winter COVID’s surge, Xavier Becerra, Secretary of the Department of Health and Human Services, will give at least another 90 days extension (beyond July 15th) to the PHE.
“It’s not that easy to enroll in Marketplace coverage, particularly for families with limited English proficiency. I worry greatly that these are the kinds of families that we’re going to lose during this process. We’re going to need a lot of community support to educate folks and help them through this transition,” said Alker.
Update contact info
Health care advocates are encouraging families to take a simple step: update their contact information.
“It is critical because the counties who are beneficiaries (of the Medicaid program) usually contact families every year through this renewal redetermination process,” explained Yingjia Huang, assistant deputy director at the DHCS. In April, the department rolled out an initiative called ‘DHCS coverage ambassadors’ to encourage community based organizations and advocates to spread the word through social media messages, flyer and calls in 90 languages other than English, so families update their addresses and phone numbers.