Hundreds of thousands of New Jerseyans could lose Medicaid coverage soon

Pandemic-era rules that allowed for continuous enrollment are ending

By: - January 23, 2023 7:11 am

Federal rules that allowed for continuous enrollment in Medicaid will lapse in April, prompting new decisions for more than 2.2 million New Jerseyans. (Photo by John Moore/Getty Images)

State officials are bracing for the end of pandemic rules that expanded Medicaid eligibility, a change that could see hundreds of thousands of residents lose their access to health care.

A federal law signed in March 2020 has required states to keep Medicaid beneficiaries enrolled during the federal public health emergency, but legislation President Joe Biden signed into law last month will see the continual enrollment provisions end on March 31. This means officials must again redetermine each year who is and is not eligible for Medicaid.

It’s unclear exactly how many New Jerseyans will be moved off New Jersey’s Medicaid plans. Nationally, the return of Medicaid redeterminations is expected to cause a 13% drop in enrollment.

State officials said they expect New Jersey to be roughly in line with the national average — that would mean nearly 230,000 New Jersey children and adults could be disenrolled — but cautioned the estimate is still imprecise at this point. In December, more than 2.2 million New Jerseyans were enrolled in NJ FamilyCare, the state’s publicly funded health insurance program for residents with low-to-moderate incomes.

Some groups are expecting an even larger drop. In a report released last month, the Urban Institute estimated enrollment in NJ FamilyCare would drop by roughly 352,000.

Assemblyman Herb Conaway (D-Burlington) chairs the Assembly’s health committee. (Dana DiFilippo | New Jersey Monitor)

Inevitably, some residents will be moved off the public plan because they no longer meet income requirements, have obtained insurance through their employer or another source since enrolling in NJ FamilyCare, or have moved out of New Jersey.

Lawmakers aren’t expecting a cataclysmic drop in enrollment. Assemblyman Herb Conaway, who chairs the Assembly’s health committee, credited the state Department of Human Services with preparing for the change.

“DHS has been anticipating this eventuality and has laid in a lot of planning and development of rules and procedures to mitigate the impact of that, and I think they feel pretty good with what they’ve done,” Conaway said. “We thought it was going to be happening earlier than this year, so they’ve laid things in place.”

Nationwide, enrollment in Medicaid and the Children’s Health Insurance Program grew to 90.9 million in September 2022, up nearly 30% from pre-pandemic enrollment in February 2020, according to research group Kaiser Family Foundation.

Officials are urging residents enrolled in NJ FamilyCare to keep their eyes peeled for redetermination documents the Department of Human Services will begin sending to enrollees in April.

“We want to avoid anyone losing coverage as a result of not responding to the eligibility process,” said Assistant Human Services Commissioner Jennifer Langer Jacobs, who oversees NJ FamilyCare. “If a family or an individual does lose coverage, they can always call our NJ FamilyCare hotline for help reapplying.”

Residents who receive a redetermination packet but do not respond in three to four weeks will be sent a letter informing them they will be disenrolled. Those disenrolled for non-responsiveness have 90 days to reapply and can seek assistance by calling the NJ FamilyCare hotline at 1-800-701-0710.

The bill signed by Biden will also wind down enhanced Medicaid fund matches states have enjoyed for much of the pandemic. They will zero out in January 2024.

Many enrollees are likely to have received redetermination letters already. State officials have been sending them for months in case the federal public health emergency was not renewed, but they should watch for new packets that will begin arriving in April. State officials expect the redetermination process to take up to 12 months.

“It’s very important that they look for that packet and respond to it as soon as it comes in,” Langer Jacobs said. “That is what will help them avoid losing eligibility.”

Some residents may be reenrolled even if they do not return their redetermination packet, as new federal rules allow states to use eligibility data for participants in the Supplemental Nutrition Assistance Program to establish Medicaid eligibility.

But officials urged residents against relying on automatic reenrollment, warning that could see some enrollees inadvertently moved off public plans.

Other rule changes have allowed greater coordination with the five managed care organizations that coordinate NJ FamilyCare plans. The state has sought those organizations’ aid to conduct outreach to residents who did not respond to previous redetermination letters.

Every NJ FamilyCare enrollee will be sent a redetermination packet on or after April 1, regardless of whether they responded to previous letters.

The state has also engaged other advocacy and community groups to aid in outreach efforts, including faith organizations, health care providers, and food pantries.

“We’ll be creating materials, creating social media ads and things of that nature. We’ll be doing community events,” said Laura Waddell, health care program director at New Jersey Citizen Action.

Waddell added her organization will help disenrolled individuals obtain health coverage through Affordable Care Act or state insurance marketplaces.



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Nikita Biryukov
Nikita Biryukov

Nikita Biryukov most recently covered state government and politics for the New Jersey Globe. His tenure there included revelatory stories on marijuana legalization, voting reform and Rep. Jeff Van Drew's decamp to the Republican Party. Earlier, he worked as a freelancer for The Home News Tribune and The Press of Atlantic City.