Article Summary –
In the process of redetermining Medicaid eligibility post-COVID-19, over 20 million people across the US have been removed from the program. Native Americans are particularly vulnerable to losing coverage and face significant barriers to re-enrolling or finding alternative coverage. The redetermination process has particularly affected rural Indigenous communities, families of color, and teen patients, leading to concerns about increased uninsured rates, disruption of health systems, and a potential rise in health disparities.
Medicaid Eligibility Redetermination Impacts Over 20 Million Nationwide
Approximately a year after the redetermination of Medicaid eligibility post-COVID-19, over 20 million individuals across the US have been removed from the federal-state program designed for low-income families. This shift has notably affected Native Americans who face greater hurdles in re-enrolling in Medicaid or securing alternate coverage.
Challenges for Native Americans During Medicaid Redetermination
Native American communities have experienced exacerbated difficulties due to the redetermination process. These populations, already facing significant issues when seeking care, have seen eligible beneficiaries losing their benefits, increasing uninsured tribal members and stressing their health systems.
Kristin Melli, a pediatric nurse practitioner, mentions how she has observed numerous patients lose coverage while seeking critical care. The loss of coverage presents an unnecessary and burdensome obstacle to patients, making securing healthcare even more challenging.
Native Americans Experience High Disenrollment Rates
Montana Democratic Senate minority leader, Pat Flowers, highlighted in early April that 13,000 tribal members in the state had been disenrolled. Despite higher Medicaid enrollment rates among Native American and Alaska Native adults than their white counterparts, tribal leaders remain uncertain about the exact number of their members who have been disenrolled.
Impact of Disenrollment on Tribal Health Systems
Disenrollment from Medicaid poses financial challenges for tribal health systems. Such systems heavily rely on Medicaid reimbursement and other third-party payers to compensate for the chronic underfunding of the Indian Health Services (IHS). Medicaid accounted for two-thirds of third-party IHS revenues as of 2021.
Experts fear that the reduction in Medicaid dollars will further amplify health disparities in Native American communities, including lower life expectancy, higher rates of chronic disease, and inferior access to care.
Lack of Data Hinders Understanding of Disenrollment Impact
One of the primary challenges faced by tribal leaders is the lack of data on the number of disenrolled tribal members and their current Medicaid status. This lack of information makes it difficult to assess the exact impact of disenrollment on their communities.
The need for more demographic reporting from more states is underscored by a KFF report, stating that current data on Medicaid unwinding by race and ethnicity is limited and not providing an accurate picture.
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