Healthcare is an important necessity in Chicago, and many Illinois residents don’t want to consider what may occur if their Medicaid benefits were to end.
A 70-year-old Cicero resident has been enrolled in the nationally and state-funded health insurance program for low-income and disabled individuals for many years. It helped to pay for his ongoing treatment and covered his heart surgery in 2015 for him.
If Salmeron lost his Medicaid coverage, he would “not have access to medical care,” he stated in Spanish. Due to his older age, he also receives Medicare, but Medicaid helps pay for a number of expenses that he would otherwise have to pay for out of pocket and be unable to afford. “What would I do?” he asked.
Many Illinois people will soon have to answer this question. As the effects of the pandemic diminish, between 384,000 and 700,000 people in Illinois are soon to lose Medicaid health coverage this year. While some individuals will find alternative sources of insurance, others will find themselves suddenly without coverage and unable to afford doctor visits or prescription drugs.
Don’t Wait Until It’s Too Late
“We are extremely worried that people are going to lose their (Medicaid) benefits and they won’t find out until it’s too late,” said Susan Vega, manager of programs at Alivio Medical Center, a federally certified health center that provides care to many Medicaid-eligible patients in the Chicago region.
What Illinois citizens need to know about Medicaid reforms is as follows:
Many changes to federal law relating to the epidemic have led to the current predicament. Prior to COVID-19, Medicaid recipients in Illinois had to reapply for the program each year, frequently by completing documentation demonstrating their continued eligibility.
The federal government started providing states with additional funding in exchange for states’ commitments not to terminate Medicaid recipients when the pandemic first started. This was to ensure that as many people as possible had health coverage. Medicaid recipients were no longer required to continually substantiate their eligibility for the program in order to maintain their coverage.
According to the state, the number of Medicaid recipients in Illinois increased from just under 2.9 million before the pandemic to 3.9 million today.
The Pandemic’s Leaving, and So Is the Healthcare
However, as the pandemic abated last year, federal lawmakers concluded that continuous Medicaid enrollment was no longer necessary, and they passed a new statute that will take effect on March 31 of this year.
As a result, Medicaid recipients will once more need to demonstrate their continued eligibility in order to maintain their coverage.
The first renewal notifications for Illinois will arrive in mailboxes in May, and they are due in June. As a result, Illinois residents will start losing their Medicaid coverage as early as July. Each Medicaid beneficiary will have a distinct renewal date, with some having it earlier and some later in the year.
Based on information from previous years, the federal government predicts that approximately 17% of Medicaid recipients may lose their coverage, which would affect about 700,000 people in Illinois. The Illinois Department of Healthcare and Family Services is more upbeat. They project that because of its efforts to assist eligible people in maintaining their coverage, only about 384,000 Illinois citizens will lose Medicaid.
Those who lose their Medicaid coverage are most likely doing so for one of two reasons: either they are no longer qualified because of their income, or they are still eligible but failed to submit the necessary paperwork.
Renew the Medicaid
If Illinois already has sufficient information about such people, it will automatically renew some Medicaid beneficiaries’ coverage. But, many more people will need to complete the paperwork.
The authorities can deliver the notices in error if people’s addresses have changed in recent years. Other times, people could just forget to complete it or fail to appreciate its significance.
Those who no longer qualify for the program—likely because they earn too much money—will lose their insurance coverage. In Illinois, Medicaid is available to anyone making up to $1,366 per month.
Health insurance through an employer may be available to those who earn too much money. Or, they can browse the Affordable Care Act’s insurance marketplace at HealthCare.gov or GetCoveredIllinois.gov.
The majority of individuals who purchase plans through the marketplace are eligible for subsidies that lower the cost of insurance. According to the federal government, around 80% of people who looked for insurance through HealthCare.gov during the most recent enrollment period were able to obtain plans for as low as $10 a month after subsidies.
Losing Medicaid
Losing Medicaid could have serious repercussions for those affected. If a person loses their Medicaid coverage and doesn’t enroll in other insurance, they might not realize they are without health insurance until they visit a drugstore or a doctor’s office.
Prescribed medicines will be a significant issue, according to Vega. When people visit pharmacies, they can start receiving bills for their prescriptions or not be able to obtain them.
Hospitals are required by federal law to treat patients who require emergency care regardless of their capacity to pay. Those folks will still be able to do so. Hospital staff will probably assist the patient in enrolling for Medicaid if they are still eligible, so that their care will be paid for. If not, the patient might be charged or the hospital might be forced to cover the expense.
Yet, even those who sign up for policies through HealthCare.gov or their employers after losing their Medicaid coverage may be in for a shock.
Written By Dylan Santoyo
Sources:
BND: Here’s what Illinoisans should know about changes in Medicaid health coverage this year.
Chicago Tribune: As many as 700,000 Illinois residents could lose Medicaid health coverage this year.
WBBM: Up to 700K Illinoisans could lose Medicaid coverage in 2023.
Top and Featured Image Courtesy of Nenad Stojkovic’s Flickr Page – Creative Commons License
Inset Image Courtesy of Shannon’s Flickr Page – Creative Commons License
