McIntyre Adrianna, Sommers Benjamin D, Aboulafia Gabriella, Orav E John, Epstein Arnold M, Figueroa Jose F
Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.
Harvard University, Cambridge, MA 02138, United States.
Health Aff Sch. 2025 Apr 16;3(5):qxaf083. doi: 10.1093/haschl/qxaf083. eCollection 2025 May.
After states initiated Medicaid redeterminations following the end of the Medicaid continuous coverage provision, millions of people lost Medicaid coverage. To date, there is limited evidence evaluating how people experienced this "unwinding" process. Using a survey of low-income adults in 4 southern states, we assessed awareness of unwinding, experience with state-based outreach, and understanding of coverage changes. Over half of respondents with some Medicaid enrollment experience (57%) reported having heard "a little," "some," or "a lot" about unwinding, with media as the most common source of information. Among respondents who reported losing Medicaid coverage, 55% reported that they thought this was because they were no longer eligible. The majority of those who lost Medicaid found out they had been disenrolled after communication from the state, but about one-quarter learned while trying to seek care. Last, nearly 50% of respondents reported losing coverage prior to April 2023, before the unwinding process began. Incomplete awareness of unwinding among people with Medicaid enrollment and confusion about enrollment status and termination timing underscore an imperative for clear communication about Medicaid benefits, particularly considering recent policies extending 12-month continuous coverage to children and postpartum enrollees. Additionally, policymakers may wish to consider new opportunities and strategies to provide enrollment resources at sites of clinical care (including pharmacies) when people unexpectedly learn about coverage loss at the point of service.
在各州在医疗补助连续覆盖条款结束后启动医疗补助重新认定程序后,数百万人失去了医疗补助覆盖。到目前为止,评估人们如何经历这一“解除”过程的证据有限。通过对4个南部州的低收入成年人进行调查,我们评估了对解除程序的知晓情况、基于州的宣传体验以及对覆盖范围变化的理解。有过医疗补助参保经历的受访者中,超过一半(57%)表示听说过一些关于“解除”的事情,听说程度为“一点”“一些”或“很多”,媒体是最常见的信息来源。在报告失去医疗补助覆盖的受访者中,55%表示他们认为这是因为自己不再符合资格。大多数失去医疗补助的人是在收到州政府的通知后才发现自己被除名的,但约四分之一的人是在寻求医疗服务时才得知。最后,近50%的受访者报告在2023年4月之前,即解除程序开始之前就失去了覆盖。有医疗补助参保经历的人对解除程序的认识不完整,以及对参保状态和终止时间的困惑,凸显了就医疗补助福利进行清晰沟通的紧迫性,特别是考虑到最近将12个月连续覆盖范围扩大到儿童和产后参保者的政策。此外,政策制定者不妨考虑新的机会和策略,以便在人们在服务点意外得知覆盖范围丧失时,在临床护理场所(包括药店)提供参保资源。