Md. health officials.  end the Medicaid redistricting with just two months left
Md. health officials.  end the Medicaid redistricting with just two months left

Md. health officials.  end the Medicaid redistricting with just two months left
State health officials are urging Marylanders to be informed about Medicaid re-enrollment. Photo by Danielle J. Brown.

The Maryland Department of Health is about to enter the final month of the Medicaid overhaul, a 12-month process that has resulted in thousands of Marylanders losing health coverage — while many others have kept coverage in a process called “unwinding.”

By the end of February, the Department of Health had processed at least 1.4 million people on Medicaid in the state to see if they were still eligible for the federal-state joint program, which provides a health plan to low-income households.

The Medicaid enrollment “cancellation” is due to a COVID-era policy that halted the annual renewal process for Medicaid enrollees to continue health coverage from year to year. From the time the shutdown began in March 2020 until March 2023, states were prohibited from disenrolling people so they could keep their coverage through the global health crisis.

After the federal public health emergency ended, the Maryland Department of Health began a 12-month process of evaluating the eligibility of just under 1.8 million Medicaid enrollees and terminating coverage for those who are no longer eligible or who do not have completed the re-application process.

Each month, the department provides Medicaid redetermination data updates. The last update was posted in March for the February redetermination period.

Each Medicaid redetermination cohort has a two-month window to complete the reapplication process after being notified of their status by the Maryland Department of Health.

There were 112,173 people eligible for redetermination for the February cohort, meaning Medicaid participants who received their notices at the beginning of the year and had a coverage cutoff date of Feb. 29, according to department data.

Of that cohort, 85,422 people retained Medicaid coverage, while 32,419 people were disenrolled, meaning they had to find health coverage through other means. There were 4,926 redeterminations still awaiting review as of March data.

The reasons for write-offs vary. In the February cohort, 4,926 people were no longer eligible for Medicaid coverage because they earned too much money or were old enough to qualify for Medicare, the federal health plan for retirees.

But most disenrollments come from so-called “procedural terminations,” meaning the Medicaid enrollee either didn’t complete the reapplying process or never started it. Some of those excluded for procedural reasons may still be eligible for Medicaid, but state health department officials often cannot verify that the reapplication was never submitted.

For the February data, 32,419 people lost Medicaid coverage for procedural reasons. There is a short grace period for those disenrolled for procedural reasons to regain Medicaid coverage if they complete their application.

People who opt out of Medicaid are encouraged to seek health coverage through the Maryland Health Benefits Exchange, which is a state health insurance marketplace created as a result of the federal Affordable Care Act.

>> TALK TO US: Maryland Matters wants to hear from people affected by changes to their health coverage during the Medicaid termination process. If you want to share your story, Press here.

Maryland Matters recently reported that the Medicaid suspension period has led to more people buying health insurance outside of the state marketplace.

But according to data from the U.S. Department of Health and Human Services, the trend is also being seen across the country, as residents of other states also had to find new health insurance policies if they were disqualified from Medicaid.

According to an HHS report Friday, about 4.7 million more people nationally have gained ACA-related coverage since 2023, with almost all of the coverage gains coming from state or federal insurance markets, driven in part by the Medicaid termination process.

“Medicaid enrollment has increased in recent years due to states implementing the ACA Medicaid expansion and the continuous enrollment condition in the Families First Coronavirus Response Act of 2020 (FFCRA), which prevented states from excluding most enrollees in Medicaid enrollees on or after March 18, 2020 as a condition of receiving a temporary increase in their federal Medicaid matching rate,” the report said. When the Medicaid phase-out began again, some of those excluded sought health insurance coverage from marketplaces linked to the Affordable Care Act.

Additional data from the Centers for Medicare and Medicaid Services said there was a 41 percent increase in Marketplace coverage during the 2024 open enrollment period, which refers to the window of time when people can buy health coverage from a federal or US market, and covers November 1st through January 15th.

“Nationally, the number of new consumers choosing Marketplace coverage during the 2024 OEP (open enrollment period) increased 41%, to 5.2 million from 3.7 million in the 2023 OEP. ,” according to recent data from the U.S. Centers for Medicare and Medicaid Services.

The increase in Maryland was smaller, with a 17 percent increase between the 2023 and 2024 open enrollment periods, according to CMS data. That means 213,895 Marylanders found health coverage on the Maryland Health Benefits Exchange in 2024, up from 182,166 the year before, the data reported.

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