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The federal government has lifted a three-year freeze that prevented states from removing people from Medicaid during the pandemic. And states are just beginning the process of assessing whether nearly 100 million low-income Americans still qualify for coverage. Experts worry millions of people who still qualify may be kicked off the rolls. Montana Public Radio's Aaron Bolton explains.
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AARON BOLTON, BYLINE: At a homeless shelter in Kalispell, Mont., Skip Hazzard is getting ready for the day. As he gathers his things, he points out his blue medical boot from a recent surgery.
SKIP HAZZARD: So three toes are gone, and that's from diabetes.
BOLTON: Hazzard says managing his diabetes and other medical issues has been hard while living in the shelter. He's been grateful for his Medicaid coverage, which pays for that care, but Hazzard is worried because he just found out the state is beginning what's known as Medicaid redetermination. Montana will assess whether all 320,000 people on its rolls still qualify for coverage.
HAZZARD: So I want to know how to get - renew it and then all that stuff.
BOLTON: The state will automatically renew some people if all of their information is up to date, but it may ask others to provide financial details or things like family size to see if they are still eligible. Nearly everyone at the shelter should qualify for Medicaid coverage. But Jodi Wagner, who works at the shelter, worries some here will be disenrolled if they don't respond to important paperwork in the mail.
JODI WAGNER: We've been getting quite a bit of mail from Office of Public Assistance every day. We make sure to get it to the ones that are still here, but it's kind of a moving target. Not everybody stays for that long of a period. And after 30 days, we do send the mail back.
BOLTON: While estimates vary, it's expected that roughly 15 million people across the country will lose Medicaid coverage during the redetermination process. Jennifer Tolbert with the Kaiser Family Foundation says that's because some will make too much money to still qualify for Medicaid.
JENNIFER TOLBERT: But we also know that about half of the people who are expected to be disenrolled will lose coverage despite remaining eligible.
BOLTON: Tolbert says people on Medicaid face all sorts of barriers when it comes to completing the redetermination process.
TOLBERT: Maybe they don't get the renewal notice in the mail. Maybe they get it, but they don't really know what the state is asking them to provide in the way of documentation. Or maybe the notice is in a language that they don't speak and so therefore don't understand.
BOLTON: Tolbert adds there are 23 million more people on Medicaid compared to pre-pandemic levels. She says state Medicaid offices might not be ready to process that many cases as they grapple with staffing shortages. States like Idaho and Montana are also trying to fast-track the process. That worries Megan Dishong with the Montana Legal Services Association. She says people can fall victim to paperwork errors that incorrectly disenroll them. Her organization does help people appeal decisions and regain coverage.
MEGAN DISHONG: We'll advise and support as many people as we can, but realistically, there just aren't the resources across the state to represent every single person.
BOLTON: Missoula, Mont., resident Jay Raines, who has diabetes, has experienced paperwork headaches before. He spent months on the phone with Medicaid trying to sort out an error that prevented him from getting supplies for his blood sugar monitor.
JAY RAINES: I really needed close blood sugar monitoring, and I wasn't able to do that. So my blood sugar was, like, totally out of control.
BOLTON: Raines got by because he had a backup plan. But he says losing coverage completely would be life-threatening because he has no ability to replace his insulin. For NPR News, I'm Aaron Bolton in Columbia Falls, Mont.
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