Why are Utahns losing their Medicaid coverage?

“Most closures are occurring simply because we get no response at all,” the Department of Workforce Services tells lawmakers.

(Francisco Kjolseth | The Salt Lake Tribune) Kids help to make signs in the Capitol rotunda on Monday, Jan, 28, 2019, on the first day of the Legislative session to rally in support of protecting Proposition 3, the Medicaid Expansion law passed by voters. Some 200,000 Utahns are no longer eligible for the insurance program, now that federal emergency COVID-19 funding is going away.

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Stephanie Burdick’s voice cracked as she addressed lawmakers on Tuesday afternoon to comment on Utah’s Medicaid unwinding process.

“Medicaid members include the children of the waitress at your favorite restaurant,” Burdick said. “The children of the custodian at your child’s school. The delivery driver for the food pantry who wakes up at 4 a.m. as she proudly works her job so that she can be done by the time her child is out of school.”

During the COVID-19 pandemic, the federal government required states to provide continuous enrollment for the health insurance program for low-income people. But with the public health emergency over, Utah and states across the nation must now review and remove people from the rolls who are no longer eligible.

As of March 2023, Utah had more than 500,000 people enrolled in Medicaid and the Children’s Health Insurance Program.

“We’ve got 200,000 more people on Medicaid than we’ve ever had in the state of Utah with a 2.4% unemployment rate,” Kevin Burt, deputy director of Workforce Services, told the Social Services Appropriations Subcommittee. “So I do want to emphasize there are more people on Medicaid than should be.”

By March 2024, the state must complete the process of reviewing the eligibility of more than half a million Utahns. In April and May 74,000 Utahns lost their insurance, The Tribune previously reported.

But some of the people losing their health insurance through the review process are still eligible.

“Most closures are occurring simply because we get no response at all,” Burt said. “And unfortunately what triggers action from the claimant is a closure notice and that’s actually proven to be one of the most effective ways, it’s not certainly the ideal way to administer the program.”

Sen. Jacob Anderegg, R- Lehi, noted that his son had recently lost his Medicaid coverage and after calling several times and facing hours long wait times gave up.

“It’s clear he got kicked off for some sort of procedural thing,” Anderegg said, “but he can’t talk to anyone to figure it out.”

He asked Burt and Utah’s Medicaid Director Jennifer Strohecker if there was a staffing shortage.

“It is two to three times the workload then we typically receive through the Eligibility Service division,” Burt responded. “So the question is, did we get two or three times more funds to be able to cover this? The answer is no. So we have seen some disruption to our service level.”

Strohecker said Medicaid administrators are trying to improve the process by automating certain parts of the review, examining cases where recipients lost coverage for “procedural” reasons and working with stakeholders. Burt advised Medicaid recipients to keep a close eye on notifications.

Resources for those with Medicaid

An article with advice on remaining enrolled in Medicaid can be found here.

The Utah Health Policy Project’s Take Care Utah program also provides help for those navigating the system.