The Medicaid Unwinding and What It Means for Virginia

The Medicaid Unwinding is one of the biggest challenges that many of our constituents will face in the coming year and community engagement is going to be crucial to make it go smoothly. This isn't just a problem for people who will lose coverage. When people are uninsured, they don't go to the doctor for preventative medicine which can result in long-term worse health outcomes, and higher costs when they eventually have an emergency. Health insurance premiums may rise for everyone to pay for that emergency care.

Below, I've summarized a few points on Medicaid unwinding from https://coverva.org/en/phe-planning.

Starting next month, Virginia will begin reviewing members’ health coverage to make sure they still qualify, however closures will not occur prior to April 30, 2023. People who qualified for Medicaid and other programs during or before the pandemic were required to stay covered through the duration of the public emergency. During that time, they may have accepted a new job and begun earning more than is allowable for the program. The Federal Consolidated Appropriations Act was signed into effect on December 23rd, 2022. This omnibus bill decoupled the continuous coverage requirement from the public health emergency effective March 31, 2023. This means on April 1, 2023, all states may return to normal enrollment processes, including redeterminations and processing reductions/closures of coverage. We have 12 months to make the transition to normal coverage.

Virginia will not discontinue coverage without asking enrollees for updated information. If someone is still qualified, they have time to provide information to the state and make sure they maintain coverage.  If the state determines that someone no longer qualifies for health coverage from Virginia Medicaid, they will get:

• Notice of when the Medicaid coverage will end,
• Information on how to file an appeal if the member thinks our decision was incorrect, and
• A referral to the Federal Marketplace and information about buying other health care coverage.

If someone is worried about losing coverage, they should:

• Update their contact information by calling Cover Virginia at 1-855-242-8282 or online at commonhelp.virginia.gov. We must have current contact information on file, such as a mailing address and phone number(s), so members receive important notices and so we can reach out if we need more information.
• Watch for and respond quickly to notices about their coverage.
• Sign up for email and text updates, follow us on social media and visit us at coverva.org and facebook.com/coverva/

Virginians who do not qualify for Virginia Medicaid can buy health insurance through http://www.enrollva.org/. Enroll Virginia has offices in communities across the state to help Virginians get high quality, affordable health coverage. You can sign up for insurance on the Federal Marketplace on HealthCare.gov:

• Within 60 days after losing health coverage or
• Anytime during the annual open enrollment period from November 1 through January 15

Virginians who do not qualify for health coverage from Medicaid may be able to get financial help to lower the cost of private health insurance through HealthCare.gov. The amount of financial help is based on the cost of insurance where the applicants live, how many people are in their household, and their estimated yearly income.

Here are some other useful links from a VPLC webinar last month:

• Webinar recording 
• Webinar slides
• Enrollment assistance locator tool
• SignUpNow Medicaid workshops 
• CMS unwinding guidance and resources
• Cover Virginia "Return to Normal Enrollment" page
• DMAS "COVID-19 and the Return to Normal Enrollment" page
• Georgetown University Health Policy Institute, Center for Children and Families "Consolidated Appropriations Act, 2023: Medicaid and CHIP Provisions Explained" report