Pandemic-Era Medicaid Enrollment Protections Are Ending
Here’s Why It Matters for Louisianans.
Louisiana, along with the nation, has entered the biggest health insurance coverage event in a decade as pandemic-era Medicaid enrollment protections end. Hundreds of thousands of Louisianans could lose coverage. And that loss of coverage could spell disaster for people who rely on Medicaid to get the healthcare they need.
Here’s how we’ve gotten here—and what we can do to help prevent the coverage cliff that looms for our state.
Are you already enrolled in Medicaid?
More than 430,000 Louisianans enrolled in Medicaid during the pandemic, and currently, over 40% of the state’s population is covered by Medicaid.
The Kaiser Family Foundation estimates that 17 million Americans — including hundreds of thousands in Louisiana — could potentially lose Medicaid coverage. This is a massive undertaking for state health departments that are already overtaxed. As the process unfolds, some current Medicaid recipients will be disqualified from the program because they no longer meet its eligibility standards. For those people, subsidized marketplace plans or employer-provided coverage will be critical in providing continued access to care.
Others, however, may still be eligible for Medicaid coverage but could lose access due to procedural reasons and red tape.
But there are things Louisiana Medicaid can do to help prevent people from falling through the cracks and losing coverage even though they are still eligible. As the state begins reviewing Medicaid eligibility again for the first time since before the pandemic began, it is critical that the Department of Health makes every effort to avoid wrongly cutting off people’s coverage due to paperwork problems and bureaucratic hitches.
To prevent eligible people from losing coverage they and their families depend on to keep themselves healthy, Louisiana Medicaid should follow the best practices outlined by the federal government and make every effort to avoid wrongful terminations. The Department of Health should be transparent about the renewal processes, take proactive steps to protect coverage, create feedback loops with on-the-ground community groups, and continuously evaluate the performance of the state’s renewal processes.
Louisiana's Medicaid Timeline
Key Dates from 2016-2024
Louisiana Medicaid’s Plan for Ending Continuous Coverage
Starting July 1, Louisianans may lose their Medicaid coverage as the state begins a 12-month process to review the eligibility of everyone enrolled in the program.
Louisiana Medicaid’s Plan for Ending Continuous Coverage
Starting July 1, Louisianans may lose their Medicaid coverage as the state begins a 12-month process to review the eligibility of everyone enrolled in the program.
The state detailed its plan for processing renewals at the end of the continuous coverage period, and they plan on distributing renewals evenly throughout the year to keep the process running as smoothly as possible. Each month, the state will process around 169,000 people’s Medicaid eligibility. Learn More
Uninsured Rate for Louisiana & United States
Fewer People Go Without Health Insurance Amid Medicaid Expansion and Pandemic-Era Protections
Public Health Insurance Keeps Louisianans Covered During Pandemic
Louisiana health insurance coverage by public and private plans in 2019 and 2021
0
Number of LouisianansCurrently Enrolled in Medicaid
0
Number of Louisiana Adults Currently Enrolled in Medicaid Expansion0
Number of LouisianaChildren Covered by Medicaid
In 2019, Louisiana Medicaid added additional barriers to consistent coverage by opting to add quarterly income checks on Medicaid enrollees. When wage checks happen, people often lose coverage not because their income increased making them ineligible, but because Louisiana Medicaid did not receive the required documentation requested from enrollees within the 10-day turnaround time.
Barriers like quarterly wage checks create a cycle where people lose coverage, usually for administrative reasons, only to reapply and regain coverage shortly thereafter. When Louisiana Medicaid unnecessarily began performing these wage verifications every few months, the more frequent checks led to more unnecessary coverage losses.
How Continuous Coverage Has Impacted Louisiana’s Medicaid Enrollment
The dips in enrollment that we see in 2019 reveal the cycle of gaining, losing and then regaining coverage, a cycle that leads to more stress for enrollees and additional barriers to accessing the care they deserve.
When the pandemic began and the continuous coverage provision started, the unnecessary additional wage checks stopped due to the continuous coverage provision. Enrollment has steadily increased since then without those dips in coverage. The continuous coverage provision eliminated the cycle of coverage loss that many Louisianans faced before the pandemic. And that means more people remained covered by stable health insurance.
With the end of the pandemic-era Medicaid provisions, Medicaid will return to normal operations, and that means those unnecessary additional wage verifications will resume this year for Louisianans.
And that means a Medicaid coverage
cliff looms for our state.
That could spell disaster for the millions of Louisianans who rely on its coverage. Medicaid provides life-sustaining health coverage and essential financial protection from debilitating medical expenses to millions of low-income Americans.
Beyond providing access to stable health coverage that allows them to go to the doctor, get their prescriptions, and stay healthy, Medicaid coverage is vital for healthy families and kids. It allows adults and children in our state to get the early care they need to thrive — both now and in the future. Research shows that being insured leads to better health, education and economic outcomes for kids.
Want to know how Medicaid positively impacts, people, families and communities in our state? Learn More
How Does Medicaid Funding Work?
Medicaid’s funding structure – and its large footprint in the state budget – make the program an important tool the federal government can use to support state finances. Prior to the Families First Coronavirus Response Act in 2020, 67% of Louisiana’s Medicaid costs were covered by federal funding, leaving the state paying 33%. But the Families First Act included a vital 6.2% increase in the federal government’s share of Medicaid costs (the Federal Medical Assistance Percentage or FMAP). This change injected approximately $117 billion in additional funding into cash-strapped state budgets, translating to an extra $2.17 billion in additional funding for Louisiana from January 2020 through March 2023.
The FMAP for Medicaid expansion was 100% in the early years of the program – in 2014, 2015 and 2016 – and gradually decreased to a fixed FMAP of 90% by 2020 with state budgets covering 10% of costs.
But that means that the federal government covers 90% of these costs, and the state’s 10% TooltipMedicaid dollars are made to Managed Care Organizations in per member per month (PMPM) payments, which then flow to medical providers like doctors and nurses in local communities. The enrollee does not receive any of
this money. Learn More is actually paid through hospital and provider payments. Louisiana taxpayers pay zero dollars toward these costs.
The federal and state dollars that flow through the Medicaid program are used almost entirely to pay private healthcare providers - doctors, hospitals, pharmacies and clinics that serve Louisiana communities.
On average the renewal process takes about 75 days to complete.
LA Medicaid runs a data check on all 169,000 individuals in June cohort.
MayMedicaid sends letters with a May 1 date out to individuals.
John: RenewedJohn works a minimum wage job as a home health aide. The data check confirms his income is low enough that he is still eligible for Medicaid and the letter states that his coverage has been renewed.
JuneEnrollees letters request more information. They have 30 days to send in their proof of eligibility to remain covered.
Sarah: Not EligibleSarah works in HR at a small business, but recently got a $2/hr raise. The paperwork she submitted confirms that she is no longer eligible.
Sarah: TerminateCoverage is terminated and Sarah is referred to Marketplace.
Jorge: PaperworkJorge earns $15/hour as a delivery driver for a major online retailer. He submits additional information requested before July 1st.
Jorge: RenewedThe additional proof submitted confirms Jorge is still eligible for Medicaid. A letter is sent to notify him that his coverage has been renewed.
Ebony: No ResponseEbony moved in the three years since the last time that LA Medicaid verified her eligibility, so she didn’t receive the paperwork. She’s still eligible (she’s a single mother of two who works at a big box store), but she doesn’t know her coverage is in danger. Medicaid does not receive proof of eligibility.
Ebony: 1st AttemptMedicaid attempts to contact Ebony via phone, email, or another address on file.
Ebony: 2nd AttemptMedicaid sends another letter to Ebony letting her know that her coverage will be terminated on July 1 if she does not prove that she is eligible.
JulyIf Medicaid has not heard back from an enrollee and cannot determine eligibility, they mail a letter that alerts the enrollee that their coverage has been terminated.
Ebony: TerminateCoverage is terminated and Ebony is referred to Marketplace.
Each Medicaid recipient will have to renew their coverage. Sometimes, that process will be easy and seamless because the state can assess their eligibility using back-end data. Louisiana Medicaid estimates that about half of Louisianans covered by Medicaid will be able to be renewed for coverage automatically, without having to fill out any forms because the state has enough information to confirm their eligibility.
But if the state lacks the information it needs to complete the automatic renewal, Louisiana Medicaid will need people to complete forms to confirm that they are still eligible.
When this happens, some people will lose Medicaid because they are no longer eligible (because their income went up, household size went down, etc.). But some people who are still eligible may lose their coverage for administrative reasons.
How February 2019 Wage Checks Impacted Coverage
Source: Medicaid Quarterly Wage Check Process: Response to HCR 43 of the 2019 Regular Legislative Session,” Louisiana Department of Health, September 2019,
We don’t know exactly how the end of the Medicaid continuous coverage provision will impact enrollees in our state. Louisiana Medicaid estimates that over 200,000 will be disenrolled for Medicaid by the end of the process. But we do know that Louisianans face a significant risk of potentially losing coverage even if they are still eligible. And that risk is even more significant for people of color and children.
We don’t know exactly how the end of the Medicaid continuous coverage provision will impact enrollees in our state. Louisiana Medicaid estimates that over 200,000 will be disenrolled for Medicaid by the end of the process. But we do know that Louisianans face a significant risk of potentially losing coverage even if they are still eligible. And that risk is even more significant for people of color and children.
# of Individuals Predicted to Lose Medicaid
Due to Eligibility Loss vs Administrative Churning
While White non-Latino-people are most likely to lose coverage due to the loss of Medicaid eligibility, other groups’ loss of coverage is more likely due to those administrative hurdles. Latinos face a particularly high risk of losing coverage even though they are still eligible. Asian and Native people, people who are multi-racial, and Black people are also all at higher risk of losing their Medicaid because of administrative reasons rather than loss of eligibility.
People who lose their Medicaid coverage during this process, whether for eligibility or procedural reasons, could experience a gap in coverage or end up uninsured, leading to disruptions in access to care.
Louisiana ranks 4th in the nation for projected increased marketplace enrollees.
Many enrollees who lose coverage because they are ineligible may see private insurance as too expensive. Some may have applied to the marketplace in the past and found that their plans were unaffordable. But in addition to increasing funding for outreach and navigators to make enrolling in marketplace plans easier, Congress greatly increased funding to help Americans pay for plans on the marketplace.
What Can You Do to Help?
Educating Louisianans about the impending end of the continuous coverage provision and what it means for their eligibility is a good first step to helping prevent loss of coverage due to administrative hurdles. Educating community members that Medicaid rules will be changing in the future and that everyone will have to renew their Medicaid eligibility and encouraging community members to double-check their address and phone number with Louisiana’s Medicaid office is key.
English | Spanish | Vietnamese
Here are some things you can do to help
Help Medicaid enrollees update their current mailing address and phone number with the Medicaid agency.
Help people who are no longer eligible for Medicaid apply for Marketplace coverage or connect them to a Navigator who can help.
Assist Medicaid enrollees through their renewal process such as by helping them complete the renewal form, gather necessary documents, and resolve any issues that arise.
Inform Medicaid enrollees that they will have to renew their coverage in 2023 and that they should watch for mail from the Medicaid agency and respond to any requests on a timely basis.
The end of the continuous coverage provision does mean changes are coming to Medicaid. Medicaid renewals will once again be sent out. You want to make sure that you can quickly and easily verify your eligibility to stay covered.
The end of the continuous coverage provision does mean changes are coming to Medicaid.
Make sure Medicaid has your current contact information, including your mailing address, phone number, cell phone number, and email address, so that you receive important letters about your health insurance coverage.
Update or make changes to your contact information by:
- Logging on to MyMedicaid.la.gov
- Emailing MyMedicaid@la.gov
- Calling your health plan on the number on your ID card
- Calling Medicaid’s Customer Service hotline at 1-888-342-6207. Hotline assistance is available Monday through Friday, 8 a.m. – 4:30 p.m.
- You can also get in-person help at any of the regional Medicaid offices. For an office closest to you, visit www.ldh.la.gov/medicaidoffices.
Check your mail, and if you get a letter from Louisiana Medicaid, read the letter and follow the instructions in the letter. The letter may require you to send Medicaid important documentation or information.
Remember — Not responding to these renewal letters or requests for information puts your coverage at risk, even if you are eligible.
*These can be used for banners, social media graphics, web graphics, etc. If you need additional materials, contact Damiane Ricks at damiane.ricks@la.gov.
Explore More
Click below to access a full list of references for this data or get to know the parties who brought you this report.
NExt Steps
If you found this report informative and educational please click and share on social media, email it to a friend or download a copy.