Nearly 130,000 low-income or disabled New Jersey residents lost Medicaid coverage over four months since the federal government required states to review eligibility for the publicly subsidized health insurance in the wake of the COVID-19 pandemic, a new report shows.
The state Department of Human Services, which oversees Medicaid or NJ Family Care, has reviewed the qualifications of almost 840,000 members since they launched the process in May, finding 15% are no longer eligible because they earn too much money, experienced a change in health status or can’t provide the proper paperwork. Some 243,000 people — nearly 30% of the members re-assessed — still met the guidelines and were reenrolled, according to the latest monthly report for August. Close to 400,000 are still under review.
Advocates for low-income residents have long raised concerns about the impact of the so-called unwinding. Human Services officials originally predicted the effort would end coverage for at least 280,000 Medicaid members over the year-long process. More recently, they flagged a federal alert that found New Jersey was among 30 states that had systems issues that could have inappropriately rejected children and families, despite the fact that they qualified.
Cause for concern
“The growing termination numbers are concerning,” said Laura Waddell, health care program director for NJ Citizen Action, which advocates for low-income residents and health care coverage. “New Jersey’s terminations more than doubled since the last report and the bulk of them are for procedural reasons. New Jersey is not alone in this, but we need to do a better job at communicating the urgency of the situation and informing our NJ Family Care residents of the process, procedure, timelines and how to connect for application assistance.”
New Jersey’s Medicaid program grew by 35% during the COVID-19 pandemic to cover 2.3 million poor, disabled and elderly residents — almost one in four state residents — thanks in part to federal orders that prevented states from performing routine eligibility reviews. But when the national health emergency ended last spring federal officials ordered states to scrub their health insurance rolls to ensure only those who proved they qualified were enrolled.
The impact of these changes could be particularly stark for people of color and those of mixed race, who together make up more than four out of five Medicaid members nationwide, studies show, something that concerns Waddell and others. “Based on what we know about inequities in our health care system and Medicaid enrollment, it’s very likely that the loss of coverage is disproportionately harming Black and Hispanic/Latinx families, even if they still qualify for low- or no-cost coverage options,” said Brittany Holom-Trundy, a senior policy analyst with NJ Policy Perspective, a progressive think tank, who is tracking the process.
Human Services officials in New Jersey pledged to proceed slowly and carefully over the full 12 months allowed. They created a website Stay Covered NJ and have placed or issued nearly two million calls, texts and postcards to members urging them to contact state officials to prove they still qualify.
Wadell said Medicaid members should look out for a renewal packet in the mail and respond within 30 days. If you are found ineligible, you have two months to file a request for a hearing, she said. “Most importantly, if you’re not sure what to do, contact NJ Family Care or an enrollment assister like NJ Citizen Action for help with your application.”
In New Jersey, Medicaid covers adults who earn up to 138% of the federal poverty limit, which translates to $2,268 a month for a couple. In the case of pregnancy, the program covers all health care needs for up to a year after birth for people who make less than 205% of the federal level, or $2,491 for an individual. Coverage for children is the most generous. Children in families that take home up to 355% (or $8,875 for four), regardless of the child’s immigration status. State officials said many of those who are no longer able to receive Medicaid will instead qualify for federal and possibly state subsidies to help purchase a commercial health insurance plan on New Jersey’s Obamacare marketplace.
The state’s Medicaid review process started slowly, and no members were terminated over the first few months, the reports show. By the end of June however, 22% of the more than 500,000 members officials checked had been renewed in the program and 2% were disqualified. By July 31 the total terminations had topped 8% and by the end of August, these accounted for 15% of all the cases reviewed.
Holm-Trundy said she is worried both about the rising number and the reasons people are being denied, noting that the vast majority of terminations to date have involved procedural problems, not higher income or a change in disability status. “These are residents who may still qualify for Medicaid, but they’re still losing their coverage because the renewal forms are too complicated, confusing, or onerous. You have to remember that many of these families enrolled in Medicaid for the first time during the pandemic, so they have never navigated this renewal process before,” she said. “This situation underscores the urgent need for clearer and more frequent communication from the state, and a better bridge to other coverage options, including auto-enrollment in the state’s marketplace.”
