One year after the termination of the pandemic-era policy allowing for continuous Medicaid enrollment, Community Health Centers and their patients are feeling the impact. Nearly one in four (23%) of health center Medicaid patients are estimated to have lost their Medicaid coverage, according to a new joint survey from NACHC and the Geiger Gibson Program in Community Health at Milken Institute School of Public Health, George Washington University. The survey was conducted during January 2024. Respondents included 222 community health centers, including look-alike health centers.
Survey finds coverage losses among patients and financial losses among health centers
- 23% of health center Medicaid patients are estimated to have been unenrolled during the redetermination process due to the end of continuous enrollment. Among unenrolled patients, most (74%) had not been reenrolled at the time of the survey. Patients who were reenrolled spent an average of two months without Medicaid coverage.
- Health centers lost $595,000, on average, because of the redetermination process. Some health centers reported no losses, and the highest reported loss was $20,000,000. Additionally, health center staff spent an average of 1,600 hours providing patient assistance during the redetermination process (e.g., outreach, renewal assistance, rescheduling).
- Most health centers (77%) avoided making reductions or cuts to services, however about one in ten reduced staff (12%), services (11%) or limited appointments (9%).
- Most health centers engaged with their state Medicaid agency for support during redetermination process and about half of state Medicaid agencies permitted the health center to assist in a transition to marketplace or commercial coverage.
Health centers assist patients with enrolling in Medicaid
Because outreach and enrollment work are fundamental to the health center mission, health center staff have been working with state Medicaid agencies to stay ahead of disenrollments, conduct outreach, and get patients enrolled in alternate insurance when possible. The survey found that most health centers have taken action to assist patients with redetermination, including:
- Contacting patients about the redetermination process (84%)
- Developing plans for those no longer eligible to transfer to other coverage (61%)
- Updating enrollee contact information in advance of redetermination (56%)
- Partnering with community-based organizations in support of educating individuals and communities (54%)
NACHC has developed resources to support health centers with Medicaid redetermination. View resources.
