Get the Daily News Digest in your inbox each morning. Sign Up

More than 100,000 Alabamians lose Medicaid, though many likely reinstated

MONTGOMERY, Ala. – Since July, more than 100,000 Alabamians have lost health care through Medicaid, though an unknown number may have already had their coverage reinstated.

The new termination data was shared Thursday by Alabama Medicaid Commissioner Stephanie Azar during a meeting of the Medical Care Advisory Committee.

“I don’t have the number directly in front of me, but I do know in the three-month period (between July and September), we have terminated a little over 100,000, but I think a good many of them have come back on,” Azar said.

Much like the rest of the country, the Alabama Medicaid Agency is currently reevaluating Medicaid eligibility on a mass scale after the expiration of federal pandemic-related protections. With those protections expiring in March, Medicaid agencies nationwide are currently sifting through their rolls to re-determine eligibility, a process known as unwinding that has resulted in millions losing health care.

The Oct. 5 meeting of the Medical Care Advisory Committee.

While the Alabama Medicaid Agency did terminate more than 100,000 recipients since July, Azar stressed that many either already have, or will have their health care coverage reinstated. Medicaid recipients have 90 days to have their coverage renewed, granted they are still eligible.

Many Alabamians who lost Medicaid coverage, according to Alabama Medicaid Division Director Felton Gretel, were terminated for procedural reasons, meaning that while they were still eligible for health care coverage, they simply failed to file the proper paperwork.

“The reason we had to do the unwinding was because during COVID, we kept everyone on whether they were eligible or not; that gave individuals a sense of complacency,” Felton said at the meeting. 

“So then when COVID ended, we really went about trying to inform everybody everything is going back to normal operations, that when the renewal comes up, you’re going to have to start completing renewals.”

Some Medicaid renewals, Felton said, were able to be executed on what’s known as an ex parte basis, an automatic renewal based on available databases. Felton said that 52% of all renewals were complete using ex parte, which she called “a pretty good percentage of people.”

Alabama Medicaid Division Director Felton Gretel.

Even though many Medicaid eligible Alabamians are able to be renewed automatically, a sizable portion have been difficult to reach, Azar said. That’s in part why the agency opted to do the unwinding process over a 12-month period.

“One of my bigger surprises is how shocked everybody across the nation seems to be about a procedural termination; we’ve been doing these for 23 years… they happen,” Azar said. 

“We don’t want those to happen to people who are eligible, that’s why we took 12 months (for the unwinding process). We’re doing everything we can; we’ve spent extra dollars to communicate through text and extra notices, quite honestly (in ways) that other states didn’t do.”

The most recent official termination data from Alabama Medicaid showed that 22,313 Alabamians lost coverage in July. During the meeting, Communications Director Melanie Cleveland explained that due to a large number of those terminated being removed for procedural reasons, and thus, eligible for renewal within 90 days, the Alabama Medicaid’s termination data is often two-to-three months behind.

Cleveland also stressed that there were often other reasons other than loss of eligibility that an Alabamian may have lost Medicaid coverage.

“Keep in mind that some of those changes might have been from somebody asking to be removed, they might have moved out of state, it might be somebody who’s passed away, but also if you have someone who’s gotten a job,” Cleveland said. “You’re going to see changes in our numbers for all of those categories.”

As to the termination figure of more than 100,000 shared by Azar, Cleveland said it was a “very rough, round number,” and reiterated that a “percentage of these are likely to return when they realize they’ve lost coverage because they have that 90 days.”

Alabama is currently one of ten states that has yet to expand Medicaid, which, according to the Alabama Hospital Association, would expand Medicaid coverage to close to 300,000 Alabamians. Alabama has among the strictest eligibility requirements for Medicaid in the country, with an adult only eligible if they are pregnant, responsible for a child, has a disability or family member with a disability, or is above 65 years old.

Democrats have pushed for Medicaid expansion in Alabama for years, with Rep. Mary Moore, D-Birmingham, having introduced a Medicaid expansion bill every year since 2018. The Republican-controlled Legislature, however, has been resistant to the idea, with House Speaker Nathaniel Ledbetter, R-Rainsville, when asked about Medicaid expansion, saying instead “we need an Alabama solution for Alabama problems.”

Get the Daily News Digest in your inbox each morning.

This field is for validation purposes and should be left unchanged.

Web Development By Infomedia