About 1,500 Vermonters — including roughly 1,000 children — will have their Medicaid benefits reinstated after the federal government warned dozens of states that their renewal process was incorrectly kicking eligible people from the rolls.
Reinstatement is already underway for individuals who shouldn’t have lost health care coverage, according to Adaline Strumolo, the deputy commissioner of the Department of Vermont Health Access, and should be complete by Nov. 1. Impacted households will receive a notice and the state’s Medicaid program will reimburse covered health care expenses incurred when they were disenrolled.
For three years during the Covid-19 pandemic, the federal government prevented states from dropping people from Medicaid. But that rule expired this spring, and states are once again required to verify that individuals are eligible for their coverage.
Many states will renew people automatically if the state has information on file that shows someone is still eligible. If eligibility isn’t clear, that person is sent a notice asking for further documentation. If they don’t respond, their benefits end.
But federal regulators wrote to Medicaid directors in late August, raising concerns that some states were conducting automatic renewals only at the household level. That means that administrators were terminating benefits for entire households if some members failed to return their paperwork — even if the state had information on file to confirm that at least some individuals within that household were eligible.
This practice disproportionately impacted children, for whom eligibility requirements are typically less strict. And, according to the Centers for Medicare & Medicaid, it violated federal rules.
Thirty states and territories have since reported to CMS that they weren’t conducting automatic renewals at the individual level as required and are now working to reinstate those affected, the federal government announced Thursday. Nationwide, an estimated 500,000 are expected to be re-enrolled.
“We absolutely share the concern around eligible Vermonters losing Medicaid and are doing everything we can to address that. Both in this context, and then in general with the restart of Medicaid renewals,” Strumolo said.
Nationally, more than 7 million people have already lost Medicaid since states began the re-enrollment process this spring, according to data compiled by KFF, a nonprofit that conducts health policy research. In Vermont, more than 15,000 people lost coverage between May and August, according to an online dashboard maintained by the Department of Vermont Health Access.
In Vermont, as with the rest of the country, most people are losing their benefits for administrative reasons — failing to return requested paperwork, for instance — not because they’ve been deemed ineligible. But Strumolo said state-level efforts to streamline the process and automatically renew more people were paying off, and noted that August’s figures looked markedly different from May and June’s.
“We have a much higher automatic renewal rate and a much lower closure rate,” she said.
Because of the summer’s catastrophic flooding events, the department also gave everyone who was due to submit renewal paperwork in July or August an extra month to do so.
