The “Unwinding” of Medicaid Coverage Will Be Difficult for Disabled Americans, Leave More People Uninsured

BY ALICE WONG in Teen Vogue: Complete Post through this link…

Disability Visibility is a column on being disabled in a nondisabled world.

Many Americans are unclear about what Medicaid actually is. In brief: Medicaid provides health insurance coverage to low-income adults, pregnant people, and children. Roughly 60% of people on Medicaid and CHIP, a program that extends Medicaid coverage for low-income children, are 26 years old or under. Medicaid is also the largest payer of long-term services and supports, another reason it is critical to millions of people.

I’ve been on Medicaid since I turned 18. It has been a lifeline because it provides personal-care services that allow me to live in the larger community rather than in a private facility. For many Americans, though, Medicaid coverage is now at risk. Under the Consolidated Appropriations Act of 2023, states will resume redetermining eligibility for all Medicaid enrollees on April 1. That means an estimated 18 million people may lose their coverage in the next 14 months, including some people who enrolled during the pandemic, according to a report from the Urban Institute. 

Like the White House’s plan to privatize COVID treatments and vaccines, Medicaid coverage is another public health emergency measure that’s been deemed no longer necessary. In early 2020, Congress enacted a rule that barred states from dropping people from Medicaid, thus ensuring access to health care during the pandemic. But now the government will allow the number of uninsured people to soar in an “unwinding” process that could have major consequences.

Every year, I have to go through a Medicaid redetermination process, which assesses my eligibility so that my coverage can be renewed. Even though I’ve been through this process seemingly countless times, when that thick packet from the county comes in the mail, it still creates a pit of dread in my stomach. One small error can be disastrous, resulting in what’s called “churn,” the gap in coverage that can lead to delays in care while people re-enroll — or people can fall through the cracks altogether. Administrative and procedural barriers can also lead to someone being dis-enrolled, with low-income people and people of color disproportionately at higher risk due to structural inequities. 

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