More than 600K people disenrolled from Ohio Medicaid coverage in 2023

For 448,433 cases―which was more than 73% of the people who were disenrolled―the beneficiaries were disenrolled due to a procedural reason, such as failure to respond, rather than being deemed ineligible, according to a Dayton Daily News analysis of Ohio Medicaid’s unwinding reports.

For 161,074 Ohioans, the state deemed them ineligible for Medicaid or CHIP benefits, referring them to the Marketplace instead. Nearly 1.9 million Ohioans have had their coverage renewed under Medicaid or Children’s Health Insurance Program (CHIP).

Going from having medical insurance to losing coverage may make people less apt to seek care when it’s needed.

“Now they’ve got to pay out of pocket, and we know that a lot of patients…they won’t seek care if they’re uninsured,” said Gregory Hopkins, executive director of the Community Health Centers of Greater Dayton.

Researchers have found that most of the people who get disenrolled from Medicaid tend to go without health coverage for a period of time post-disenrollment, according to KFF, a nonprofit health policy research and news organization.

Using pre-pandemic data, KFF found in the year following a disenrollment from Medicaid/CHIP, roughly two-thirds (65%) of people had a period of uninsurance. There were also roughly four in 10 (41%) people who disenrolled from Medicaid/CHIP eventually re-enrolled in Medicaid/CHIP within a year.

The Community Health Centers of Greater Dayton has not seen a significant change in the payor mix of their patients since the redetermination process began. Hopkins said they were proactive in talking with their patients and sending out letters last year to make sure they knew they needed to go through the renewal process on their Medicaid coverage.

In Montgomery County, there was an average of 4,382 renewal packets sent out each month in 2023 following the end of continuous enrollment, according to the Montgomery County Job Center. January is projected to have about 4,242 renewal packets sent out.

“There have been multiple community outreach efforts at the federal, state and county level,” said Reba Chenoweth, public information officer for human services at the Montgomery County Job Center. “These have included billboards, mailings, robocalls, text messages, external media coverage and social media campaigns, among others.”

In March 2023, Montgomery County had approximately 192,564 Medicaid recipients. Currently, Montgomery has around 176,891 Medicaid recipients.

“It’s important to note that any fluctuation in Medicaid recipient totals can be due to multiple possible variables including failure to meet eligibility requirements, failure to comply with the recertification process, moves out of state, self-unenrollment and death, among others,” Chenoweth said.

In Butler County from April 2023 through December 2023, there have been 49,258 Medicaid renewal packets out.

“The redetermination process has been going fairly well in Butler County, with staff working extra hours to ensure timeliness,” said Julie Gilbert, executive director of the Butler County Department of Job and Family Services.

There have been more than 7,000 renewal packets sent out in Clark County, according to the Clark County Department of Job and Family Services. The department has completed approximately 6,200 reenrollment requests, said Virginia K. Martycz, director of Clark County DJFS.

“It’s an ongoing process,” Martycz said.

One of the options for people who are no longer eligible for Medicaid is to go through the Affordable Care Act’s Marketplace. Clark County has had nearly 1,000 applicants in the Marketplace since early October.

Since the redetermination process has been going on, Martycz said Clark County DJFS had had about 18,000 appointments scheduled for the different benefits impacted by the end of the COVID-19 public health emergency.

Ohio Medicaid helped provide extra funds for staff overtime costs, along with some automated resources, to help with the redetermination process.

“We just ask people to be patient because we’re processing things as quickly as we can. We want it to be accurate, and we want the benefits to be fair for everyone,” Martycz said.

Clark County has also had a growing Haitian immigrant population with which Clark County DJFS is also working. An estimated 5,000 to 10,000 Haitians have settled in Springfield, mostly in the last five years.

Ohio ranks as the fifth highest state with the most people disenrolled from Medicaid, according to KFF. The state is preceded by Texas, Florida, California, and New York.

In looking at the rate at which people are disenrolled from Medicaid, KFF’s analysis has Ohio ranked at number 40, in the bottom dozen of states. Ohio has disenrolled about 25% of Medicaid beneficiaries, according to KFF, compared to Texas at the highest with 61% disenrolled and Maine at the lowest with 13% disenrolled.

Across all states with available data, 71% of all people who were disenrolled had their coverage terminated for procedural reasons, KFF said.

The state will likely be finishing up the unwinding process around March of this year.

For state fiscal year 2023, Ohio spent approximately $36.1 billion, including both state and federal funds, on the Medicaid program as a whole.

For people who are no longer eligible for Medicaid coverage, they may be able to buy health coverage through the federally facilitated Marketplace at healthcare.gov.

“These historic enrollment numbers are a testament to the need for comprehensive, quality, affordable health insurance, and we must do everything we can to protect and expand access to coverage for all people,” said Chiquita Brooks-LaSure, administrator for the Centers for Medicare and Medicaid.