With 72,500 at risk of losing Medicaid, DHHS moves from friendly to urgent ‘contact us’ letters

By: - February 7, 2023 6:30 am

The Department of Health and Human Services estimates about 30,000 people could no longer qualify for expanded Medicaid once it reviews their eligibility this year. The New Hampshire Fiscal Policy Institute looked at the demographics of expanded Medicaid recipients in a January report. (Screenshot)

The federal government’s announcement that it’s ending several COVID-19 protections should be of particular interest to the approximately 72,500 Granite Staters who will lose their Medicaid coverage if they don’t get in touch with the Department of Health and Human Services – and soon.

The expiration of those federal protections also ends the “continuous enrollment” that has allowed people to remain on Medicaid without having to show they still qualify. Beginning April 1, the department will resume its pre-pandemic annual review of recipients’ eligibility, a process called “redetermination.” 

A massive public awareness campaign last year prompted nearly 30,000 people to complete their redetermination ahead of the March 31 deadline. The approximately 72,500 people who have not completed redetermination will face one of three outcomes.

  • If the department doesn’t hear from them by the time their current benefits end, they will no longer have Medicaid coverage. 
  • If they complete the redetermination process and continue to qualify, they’ll keep their Medicaid benefits.
  • If that redetermination process shows they no longer qualify, most likely because their income has gone up, they will get help exploring other options, such as a federally subsidized health plan.

With the March 31 deadline less than two months away, the department is escalating its outreach campaign. The friendly redetermination reminders it sent Medicaid recipients last year on pink paper have become more urgent reminders printed on yellow paper.

“The yellow letter is really your signal that something has changed and you need to pay attention,” said Henry Lipman, the state’s Medicaid director, in a press event on Jan. 31. “If you don’t understand what you’re reading, reach out. We want to help. I think the bottom line is our mission here is if you should have coverage, we don’t want you to lose it.”

Here’s what you need to know.

Expanded Medicaid recipients are more likely to lose benefits than those on standard Medicaid.

Medicaid enrollment surged nationwide and in New Hampshire when the pandemic and a child care shortage forced people out of work, leaving them in need of financial assistance. 

That was particularly true for Granite Advantage, the state’s expanded Medicaid program, which saw an 85 percent increase, going from 51,000 recipients to over 95,000, Lipman said. Eligibility requires only that someone be between 19 and 65 and earn less than 138 percent of the federal poverty level. In 2022, that equaled $18,754 a year for a single person and $38,295 for a family of four. Pandemic-related job losses made a lot more Granite Staters eligible.

Standard Medicaid grew by about 22 percent because it’s harder to qualify. Beneficiaries must be low-income and have a physical or developmental disability or be younger than 19, pregnant, or caring for children or other family members. 

A lot of those out-of-work Granite Advantage recipients have resumed working and are less likely to still qualify, Lipman said. He estimated those rolls could drop by about 30,000, from 95,000 beneficiaries to 65,000.

Benefits will end gradually.

In the next two weeks, the department will be reaching out to Medicaid beneficiaries by mail and through their NH EASY accounts, the online portal to state benefits and resources, to let them know when their redeterminations are due. About 45 days prior to this date, individuals will receive their redetermination notices in order to give them time to complete them and send them in, the department said.

New Hampshire will look first at people whose benefits are set to end on March 31, the deadline for redeterminations. But it will also prioritize people who have not used their benefits for the past year, are no longer in touch with the department, or are known to no longer qualify financially, Lipman said. 

He said the department will leave children, people in long-term-care settings, and those who are otherwise vulnerable to the end. This so-called Medicaid “unwind” is expected to take about a year.

Those who no longer qualify will not lose benefits immediately. Lipman said they will remain available for one year after the department has ruled a person no longer eligible. 

But there’s a reason to act now. 

Those who no longer qualify for Medicaid may be eligible to buy federally subsidized health insurance through the Marketplace. The enrollment period closed Jan. 15, but the Centers for Medicare and Medicaid Services announced last month that it will hold a special enrollment for people who lose their Medicaid benefits, from March 31 to July 31.

There’s lots of help available.

Lipman said the department has increased its call center by 30 people to handle what it expects to be a crush of last-minute redetermination requests. 

The department suggests people visit nheasy.nh.gov, the state’s online portal to government benefits and local services. The department can also be reached by phone at 1-844-ASK-DHHS (1-844-275-3447), or in person at one of the department’s local offices.

The state’s two federally funded health care “navigator” programs can also assist people with eligibility questions and insurance options, and help them buy a plan through the Marketplace during the special enrollment period.

First Choice Services (firstchoiceservices.org) and Health Market Connect (hmcnh.com) both provide free assistance in multiple languages. The New Hampshire Insurance Department is  another option.

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Annmarie Timmins
Annmarie Timmins

Senior reporter Annmarie Timmins is a New Hampshire native who covered state government, courts, and social justice issues for the Concord Monitor for 25 years. During her time with the Monitor, she won a Nieman Fellowship to study journalism and mental health courts at Harvard for a year. She has taught journalism at the University of New Hampshire and writing at the Nackey S. Loeb School of Communications.

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