Millions of Americans could face hurdles in keeping their Medicaid coverage next year, and a new survey found nearly half of program recipients are unprepared to navigate the changes. Starting January 1, certain adults will have to demonstrate at least 80 hours per month of work, education, community service or other qualifying activities to enroll in or maintain their Medicaid coverage. With the changes pending, a new survey commissioned by Aeroflow Health found that while 63 percent of respondents said they were aware of the coming requirements, 44 percent said they were not prepared to submit the documentation needed to comply.
Medicaid provides health coverage to lower-income Americans and is financed by both the federal government and states. The new requirements mark a major change to eligibility for many working-age adults previously covered by the program. Under rules of the Centers for Medicare & Medicaid Services (CMS), the requirement generally applies to non-pregnant adults ages 19 through 64 who are not enrolled in Medicare and who receive coverage through the Medicaid expansion population or certain Section 1115 demonstration programs.
Those affected by the change can satisfy the new requirement through at least 80 hours per month of qualifying activities, which can include employment, work programs or community service. Enrollment in an educational program at least half time can also qualify, and the activities can be combined. However, experts say, the stakes go beyond whether beneficiaries actually work enough hours.
"One of the biggest concerns with Medicaid revisions was additional requirements that most beneficiaries would fail to realize only after their implementation," Alex Beene, financial literacy instructor for the University of Tennessee at Martin, told Newsweek. The Aeroflow Health findings suggest that some people who are eligible for coverage could still struggle with the administrative process needed to prove it. "People should not lose Medicaid coverage because the reporting process was confusing, especially when they have met the requirements or qualify for an exemption," Casey Hite, CEO of Aeroflow Health, said in a statement.
"That is the risk our findings expose. Awareness is not readiness." Although nearly two-thirds of the Medicaid members surveyed knew the requirements were approaching, being ready for them was a different matter. Roughly 44 percent said they were not ready to submit the required documentation, and 46 percent said they had received no reminders about the coming mandates.
Another 42 percent said they received between one and three reminders. One-third said their biggest concern was figuring out whether they qualified under the new rules. "This new rule covers ages 19-64 and while there will be exceptions, for the majority of beneficiaries, this is the new normal," Beene said.
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