The experience of Jonnell Wieder and her daughter Oakleigh McDonald sheds light on the challenges faced by eligible Medicaid beneficiaries during the unwinding process that occurred after the end of the covid-19 public health emergency. Wieder, a member of the Confederated Salish and Kootenai Tribes in Montana, relied on Medicaid for herself and her daughter until she earned too much money to qualify for coverage. Despite having access to some health services through her tribe’s clinics, Wieder needed Medicaid to ensure comprehensive care for Oakleigh.
When Wieder tried to enroll Oakleigh in Healthy Montana Kids, the state’s version of the Children’s Health Insurance Program, the paperwork got caught in a backlog and Oakleigh lost coverage when she turned 1. It took six months for Wieder to get Oakleigh covered again, with the help of tribal health workers who resubmitted the application. This situation exemplifies the chaos that unfolded during the unwinding, leading to millions of people losing coverage due to procedural issues.
With the new federal Medicaid work and eligibility requirements set to be implemented by the start of 2027, tribal health leaders are concerned about potential disruptions in health coverage for Native Americans. While Native Americans are exempt from the new work requirements, the procedural challenges that arose during the unwinding could resurface, putting vulnerable populations at risk.
The recent changes to Medicaid rules, including the requirement for certain recipients to log 80 hours of work or qualifying activities per month, pose a significant challenge for states and beneficiaries alike. The Congressional Budget Office estimates that the new law will reduce federal Medicaid spending by over $900 billion over a decade and lead to an increase in the number of uninsured individuals by 10 million.
Native Americans, who rely heavily on Medicaid to access essential health services, are particularly vulnerable to procedural disenrollment. The unwinding process highlighted the complexities and vulnerabilities of Medicaid eligibility checks, with millions of individuals disenrolled for procedural reasons. The lack of data on how the unwinding affected Native American enrollees makes it difficult to address disparities and implement effective policies.
As states prepare to implement the new Medicaid requirements, tribal health leaders are working to ensure that Native American enrollees are not unfairly disenrolled. Challenges such as unreliable mail service, lack of internet access, and frequent address changes on reservations make it difficult for tribal citizens to maintain their coverage. It is crucial for states to improve their systems and provide support to vulnerable populations to prevent unnecessary disenrollments.
Despite the unwinding coming to an end, many challenges persist, with eligible patients still struggling to regain Medicaid coverage. Tribal health workers are actively assisting individuals who were disenrolled during the unwinding process and helping them navigate the reenrollment process. The lessons learned from the unwinding underscore the importance of streamlining Medicaid eligibility checks and providing adequate support to ensure that eligible individuals maintain their coverage.
In conclusion, the unwinding of Medicaid coverage revealed the complexities and vulnerabilities of the system, particularly for Native American populations. As states prepare to implement new Medicaid requirements, it is essential to address the underlying issues that led to widespread disenrollments and ensure that vulnerable populations receive the support they need to maintain their coverage.
