Uninsured rises in Alabama as Medicaid pandemic protection ends

Alabamaans who received Medicaid during COVID-19 may lose health coverage this spring when pandemic containment measures end.

Pandemic-era safeguards that have prevented states from removing ineligible individuals from Medicaid lists will expire beginning in April this year. About 61,000 Alabamaans are expected to lose their Medicaid health coverage by June 2024, according to a report by the Robert Wood Johnson Foundation and Urban Institute.

States may begin dropping individuals who are no longer eligible due to a change in income starting in April 2023 if they have not updated the state of a changed address or other reason. This lasts until June 2024.

Jennifer Harris, health policy attorney for the Alabama Arise advocacy group, said she’s concerned that some people who may not realize their insurance is ending or need to take steps to prevent losing their Medicaid while they’re through the stitches are falling process.

“Many people may not be familiar with Medicaid eligibility and how Medicaid determines eligibility annually versus ‘I received Medicaid during the public health emergency and I never understood or was never clearly told, that this would not normally be the case continuously over several years,’” she said.

Harris is the chair of the Alabama Medicaid Unwinding Task Force, which has worked with state Medicaid officials to try to prevent such problems when protection ends in April.

Language barriers could be an issue for some Alabamaans to understand the changes, Harris said. Others who have changed their address may not be aware that they must update the state of their new address to maintain their Medicaid health coverage.

In Alabama, the number of uninsured residents is expected to increase 16 percent, according to the Robert Wood Johnson Foundation and Urban Institute report. By June 2024, Alabama would have a total of 432,000 uninsured residents.

“Some of the people most likely to transition in and out of Medicaid eligibility include young adults, workers with part-time jobs, and people with incomes near the eligibility limit,” the report noted.

People who receive letters telling them they are no longer eligible for Medicaid insurance can appeal the decision. For those who lose insurance coverage, they would have the option to purchase insurance through the federal health care market or get it through work if possible. Children are eligible for ALL Kids coverage, and their parents should receive a letter with an option to renew their coverage, Harris said.

In Alabama, a family of two earning more than $3,300 a year is not eligible for Medicaid. A family member must also be a primary caregiver for children to qualify.

Some states have expanded Medicaid to address this coverage gap, but Alabama has not.

Many people who have minimum-wage jobs and don’t get health insurance through work make too much to qualify for Medicaid but too little to afford health care elsewhere, she said.

“There will be some people who don’t even have affordable options in the (federal) market,” Harris said.