Kentucky families must renew Medicaid for first time since pandemic. Here's what to know
During the COVID-19 pandemic, Kentucky halted annual Medicaid renewals, allowing participants to automatically be reenrolled. In 2023, the state ended that policy, requiring Medicaid recipients to go back to submitting enrollment paperwork every year — except for those in the Kentucky Children's Health Insurance Program (KCHIP).
KCHIP is a free health insurance program for families with an income at or under 218% of the federal poverty level — or up to $70,000 per year for a family of four. Children under 19, pregnant mothers and mothers within one year of postpartum are eligible to receive KCHIP coverage.
When recertification resumed in 2023, the state introduced several flexibilities to ensure vulnerable populations could remain covered, including extending automatic renewal for KCHIP participants. The goal was 'simplify the renewal process, reduce inappropriate terminations and allow the state to manage the increased workload,' according to a document from the Kentucky Department of Medicaid Services.
Now, that flexibility is ending, meaning thousands of Kentucky families will start receiving notices to update and recertify their Medicaid eligibility.
Here's what to know.
Families will get a letter when it's time to recertify and should watch for notices by mail, phone and email.
There are also several ways to check Medicaid eligibility and recertify if needed.
Visit kynect.ky.gov/benefits.
Call 855.4kynect (855.459.6328) to speak with a caseworker.
Visit your local Department for Community Based Services office.
Contact a state kynector for assistance through kynect.ky.gov/benefits/s/auth-reps-assisters.
Once enrolled, coverage lasts for 12 months. Even if changes make families ineligible for the program, children retain coverage for the year.
Families can miss notifications to reenroll for a lot of reasons, said Bart Irwin, CEO of Family Health Centers, a nonprofit primary care provider with locations across Louisville. Maybe they've changed addresses, incorrectly filled out paperwork or missed deadlines — but that doesn't mean they are not financially eligible for Medicaid or KCHIP.
"There's a connection that if parents or caregivers lose Medicaid, it's highly likely a child will lose Medicaid too," Irwin said. "I don't quite understand the connection, but one [reason] I would think is that if the parents miss the opportunity or don't respond correctly to the state's inquiry on their own behalf, it's likely they're not going to on their child's behalf, too."
If someone does not respond to a renewal by the deadline, they will be unenrolled from coverage. KCHIP participants and families can call 855-459-6328 as soon as they learn they are unenrolled for lack of response. If they are determined eligible within 90 days of termination, coverage may be rolled back to the day of termination.
Irwin said recertification for the KCHIP program could artificially deflate Medicaid rolls, similar to when the state stopped automatic enrollment for adults on Medicaid in 2023. Between April, when recertification restarted, and December 2023, Jefferson County saw more than 28,500 drop off the program's rolls, according to data from the Cabinet of Health and Family Services.
Children make up a substantial portion of Medicaid recipients in Jefferson County, with over 108,000 kids receiving coverage. A third of Family Health Centers' Medicaid patients are children under 19.
"It would be the same process as going through our kynectors and helping them redo certification, we know they're eligible, right?" Irwin said. "It's going to be the bureaucratic process that's going to harm the kids. It's missing the letter, or not putting the right information in, or forgetting some information, that's what's going to knock kids off."
Reach reporter Keely Doll at kdoll@courierjournal.com.
This article originally appeared on Louisville Courier Journal: Kentucky families must again renew Medicaid. Here's how to recertify
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Pushing Health and Private Insurers Forward Gruber: Everybody talks about how the private sector is innovating, but in fact, all the innovation in medical compensation over the past 50 years has been by Medicare, and the private sector just copies them and pays X% of Medicare. I feel like Medicare could be much more innovative. Like I said, the physician reimbursement system is largely broken. Medicare could have invested a lot more — and should invest a lot more — in thinking about answering some of the hard questions we've raised today about what is the appropriate use of prior authorization, what are the appropriate rates to pay? These are important topics that Medicare should be taking the lead on understanding, experimenting with through CMMI [the Center for Medicare and Medicaid Innovation], which can run pilots, and actually trying to be much more innovative in how it sets payment policy. Fegan: I agree with both of the previous speakers. Medicare has succeeded in providing access to care to a very vulnerable population and has succeeded in providing assured compensation for the providers who take care of that population. It's one of the reasons why I've spent the past 30 years advocating for a Medicare for All that we could afford, to take care of the entire population with the program, with some improvements that we've alluded to during the discussion today. But Medicare has been a success. What it set out to do, which was to offer care and ensure that care would provide compensation for the people who delivered it — I think that we are a better society because of that. We certainly spend enough on healthcare in this country; we just fail to provide care to everyone who needs it. We allow too many people who are not engaged in the delivery of care to take profit from it. There's a lot of opportunity to address the fraud and abuse, and we just fail to do so. Part of the problem is because we have three healthcare lobbyists for every single member of Congress. Congress tends to hear those lobbyists over the cries of the public, which would really benefit from a universal healthcare system. Brull: Thank you all for joining us today and for such a productive discussion. We appreciate your time and expertise.
