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Perhaps the most consequential change ahead is the looming loss of Medicaid eligibility for millions of low-income Americans. As part of a spending bill signed into law in December, states will soon begin a redetermination process for deciding Medicaid eligibility. Disenrollments can begin as soon as April. As many as 18 million enrollees may lose coverage. The U.S. Department of Health and Human Services predicts that people of color are much more likely to lose coverage based on administrative hurdles alone, even if they remain eligible for Medicaid.
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There are actions states should take now to prevent worsening COVID inequities. State governments can start by encouraging those who lose Medicaid coverage to get alternative coverage that will provide COVID benefits. Many will be eligible for free or reduced cost plans in the Affordable Care Act marketplace. Rhode Island is launching a program to automatically enroll those who lose Medicaid coverage during unwinding into a marketplace plan. Other states, like Maryland, plan to use navigators to contact those no longer eligible for Medicaid to help them enroll in a qualified health plan.
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