Some Alaskans start losing Medicaid coverage as state begins reviewing eligibility after pandemic pause

Nearly 3,000 Alaskans were dropped from Medicaid this month as the state resumed its annual eligibility reviews, which had been paused during the COVID-19 pandemic.

According to new data released by the state health department, more than a third of the approximately 6,500 Alaskans whose eligibility was reviewed in May, or 36%, were dropped from the program after state workers determined they were no longer eligible.

About 30% were renewed; 27% had applications that were still pending; and 7% were dropped from the program because the state didn’t have an up-to-date address on file for them.

While the state is still early into its review process, the new data is a sign of what Alaskans might see as the state continues evaluating recipients’ Medicaid eligibility over the next year and a half. Approximately one in three Alaskans is currently enrolled in the state’s Medicaid programs, which are sometimes referred to as DenaliCare and Denali KidCare, and thousands could lose their coverage in the coming months.

Under a provision in the federal health emergency that began in March 2020, Alaskans who might otherwise have lost Medicaid coverage due to a new job or other change in status were able to keep their coverage for the last two years without needing to submit annual paperwork — even if their income rose high enough that they were no longer eligible for the program.

Medicaid recipients include eligible low-income adults, children, pregnant women, older adults and people with disabilities. States administer the program, which is funded jointly by states and the federal government.

The pandemic provision extending Medicaid coverage ended this spring, prompting Alaska — along with other U.S. states — to begin the massive undertaking of reviewing Medicaid eligibility.

Nationwide, more than a million people have been dropped from Medicaid in the past couple months. The earliest Alaskans were dropped from the program was June 1.

Of the Alaska Medicaid renewals processed in May, a little less than a third were renewed in the program, and 7% were dropped from the program for what the state called “procedural reasons.”

In most cases, “procedural reasons” refers to when the state doesn’t have an up-to-date address for a recipient on file or doesn’t receive required paperwork proving eligibility for the program, according to Deb Etheridge, director of the Alaska Division of Public Assistance, which is responsible for administering federal benefits and processing the renewals.

“That’s the biggest problem we have right now, not having current addresses,” Etheridge said in an interview Friday. Nationally, many have gotten dropped from Medicaid for not filling out paperwork.

A little less than a third still had applications pending due to incomplete information. Alaskans have 90 days to respond to requests from the state for paperwork related to their eligibility.

Etheridge said the 36% ineligible rate was a fairly typical statistic for pre-pandemic renewals. Usually between 12% and 34% of people up for renewal are dropped from Medicaid, “so while we’re on the high end, we’re not far off the normal range,” she said.

“People do go off Medicaid at renewal times,” Etheridge said. “That’s kind of normal.”

The state is required to report its Medicaid data each month to the federal Centers for Medicare and Medicaid Services, which Etheridge said would be posting state-by-state data publicly beginning in July.

[Q&A: Thousands of Alaskans on Medicaid could lose coverage in the coming months. Here’s what to know.]

Etheridge said that overall, the renewal process “is going really well” so far. The Division of Public Assistance, which has struggled over the past year with a massive backlog in application processing for food stamps and other public assistance benefits, is still understaffed with about a 14% vacancy rate despite an “aggressive” push to hire more eligibility technicians in recent months, she said.

There is a separate team dedicated to the Medicaid renewals, and Etheridge said the team is managing the substantial workload well so far. They’re working on processing as many applications automatically as they can.

“It’s a little too early for me to see if there is something additional procedurally that we can do to ensure all eligible Alaskans maintain their coverage, but we’re trying to be very proactive,” she said.

Last month, the state received “verbal confirmation” from the Centers for Medicare and Medicaid Services that Alaska would be able to extend its annual renewal period from 12 months to 18 months to stretch out how long the state has to work through the thousands of applications now up for renewal.

Etheridge said that as far as she knew, Alaska was the only state to have received an extension. That was prompted by tribal health leaders who expressed concern about the state being able to get ahold of people during the summer and fall, when many Alaskans might not be able to promptly respond to requests for paperwork verification needed to complete their renewals, she said.

“Our tribal partners really expressed concern about just, you know, outreaching that many individuals during times when they might be at fish camp or hunting, so they lobbied for this change,” Etheridge said. The extension “really was CMS acknowledging that we have unique situations for our rural population who may have difficulty with mail or connectivity, who live a subsistence lifestyle.”

Officials in Alaska have said they won’t know exactly how many people in total could lose coverage until they look at each case, which will happen gradually over the next 18 months.

Between April 2019 and December 2022, the number of Alaskans enrolled in Medicaid increased by about 22% to 260,000, part of a national increase in Medicaid enrollees during the pandemic.

In Alaska, the increase has been linked to a historically low uninsured rate in the U.S. and in Alaska — 12% now in the state, compared to 19% just a few years ago, the director of the Alaska Division of Insurance has said.

Etheridge urged Alaskans on Medicaid to check their mail regularly for correspondence from the state, and to update their contact information with the state if their address has changed at all in the last three years.

So far, more than 400 Alaskans have lost Medicaid coverage because the state wasn’t able to contact them, Etheridge said.

Alaskans can update their contact information online or by calling the state’s Medicaid Information Update Hotline, 1-833-441-1870, which is staffed by a team dedicated to process contact information changes and was established to reduce wait times through the virtual call center. That hotline currently only has about a minute wait time, Etheridge said Friday.

Alaskans who have questions about their eligibility or other coverage options if they’re dropped from Medicaid can dial 211, call 800-478-2221, or visit 211′s website at alaska211.org to ask for a free appointment with a health care navigator.