Co-Authored by Chini Krishnan, CEO, GetInsured and Allison Sesso, CEO, RIP Medical Debt

There has been heightened media coverage around states’ unwinding of one of the last vestiges of the Public Health Emergency (PHE). The Medicaid continuous coverage mandate afforded millions of Americans health care coverage over the last three years regardless of their eligibility. Officials are now in the process of redetermining eligibility and already, over one million individuals (about the population of Delaware) have been disenrolled—and it could get worse. The Kaiser Family Foundation has estimated that up to 15 million people are at risk of losing health insurance coverage. Although many will transition to other coverage options, nearly four million people are likely to become completely uninsured.   

Without health coverage, individuals may delay or defer necessary medical care. When they do seek medical care, their conditions may have become more advanced, requiring more expensive treatments that lead to higher medical bills. Those health care costs can add up fast and quickly become unaffordable, especially for individuals with chronic or complex medical conditions – leading to crippling debt.  

The $195 billion in health care debt is a financial albatross for millions of Americans and their families. Nearly half of U.S. adults struggle to afford out-of-pocket health care costs, and for Black, Hispanic, and low-income adults, that number increases to six out of ten. According to a survey done by LendingTree, lower earners are twice as likely to have medical debt than higher earners; 28% of those with an annual income of $35,000 or less say they have medical debt, versus 14% who make $100,000 or more a year. Households without full health insurance are nearly twice as likely to have medical debt; 31% versus 16% of fully insured households. Interestingly, states that have expanded Medicaid enrollment have seen corresponding declines in medical debt collections.   

States have a range of preparedness levels when it comes to processing Medicaid redeterminations depending on their capacity and quality of data. Many individuals will lose coverage simply due to the administrative process because their contact information is outdated. Millions of others may become eligible for $0 or low-cost plans on their state health insurance exchange — but may not know it, or even understand how to apply. These people may also fall prey to inadequate, low-cost, short-term medical plans. This is why it’s critical that Medicaid recipients ensure that their most recent contact information is on file with their local agency.   

During the first six months of the pandemic alone, temporary changes of address with the United States Postal Service were up 26.7% over the previous year; permanent changes were up 2%. These are only the changes that were reported. For many, it has been three years since they’ve had any contact with their Medicaid office, so the addresses on file are outdated. Without the most recent mailing address for recipients, any communications sent through the mail about eligibility, enrollment, or redeterminations, will not reach them.   

The Medicaid continuous coverage mandate sparked a record-low uninsured rate for the nation and provided critical coverage for millions of Americans amid a health care crisis. That’s tremendous progress we don’t want to lose—working together will ensure that doesn’t happen.