Rédaction Africa Links 24 with Annalisa Merelli
Published on 2024-04-08 22:35:32
States began the process of Medicaid redetermination a year ago, unfreezing their Medicaid rolls that were previously frozen due to the Covid-19 emergency period. According to data from KFF, approximately 20 million people, or 21% of those enrolled prior to redetermination, lost coverage, while 42 million, or 45%, were confirmed to remain covered. Renewal of coverage is still pending for the remaining 31 million individuals.
The redetermination process not only affected individual patients but also had a significant impact on community health centers, which serve around 15% of all Medicaid patients. Data from the National Association of Community Health Centers (NACHC) revealed that, on average, these centers lost 23% of their Medicaid patients due to redetermination. This led to a substantial loss of revenue, with an average of $600,000 per health center.
The patient base of community health centers primarily consists of individuals at 200% or less of the federal poverty line. Medicaid enrollees make up about 40% of the patients at these centers, whose mission is to provide healthcare regardless of patients’ ability to pay.
The impact of disenrollment varied widely among states, ranging from nearly 60% of Medicaid patients losing coverage in Utah to 12% in Maine. Community health centers in Colorado, Florida, Washington, and Texas experienced the largest losses, both at individual centers and across the states.
While about a quarter of the centers reported no losses, some centers saw significant financial impacts, with losses exceeding $1 million for more than 20 centers. Despite the financial challenges, most health centers managed to avoid cutting services or personnel. However, some centers had to make adjustments, such as reducing staff, services, or appointment availability.
The loss of coverage following redetermination has surpassed predictions, partly due to individuals, including children, being removed from the Medicaid lists for procedural reasons. Health centers had to bear the extra costs of helping patients understand their eligibility status, which required additional administrative work and outreach efforts.
Even in states like North Carolina, which expanded Medicaid eligibility, community health centers faced challenges as they navigated the redetermination process. Centers had to engage in significant outreach and administrative support to assist patients with enrollment problems.
The additional administrative costs of supporting patients with eligibility issues have strained community health center resources. Despite the challenges, centers continue to provide essential care to patients, including those who are now uninsured due to loss of coverage. The increased outreach and enrollment efforts have resulted in centers spending an average of 1,600 extra work hours over the past year.
In conclusion, the Medicaid redetermination process has had a profound impact on both individual patients and community health centers. The loss of coverage has placed financial strain on health centers, affecting their ability to provide additional services and support to their patients. As the process continues, it will be crucial for health centers to adapt and find ways to sustain their mission of providing healthcare to those in need.
