Thousands of Minnesotans could lose health insurance if they don't take action

Minnesota is fast approaching its first deadline for making sure thousands of state residents don't unnecessarily lose their health insurance coverage from Medicaid and related health insurance programs.

Beginning in July and continuing over the next year, about 1.5 million Minnesotans currently enrolled in the government-sponsored programs must go through a process to renew eligibility for benefits.

Such verification used to be routine, but was suspended during the COVID-19 public health emergency. As a result, enrollment in the health insurance programs, which are jointly funded by the state and federal governments, grew by more than 360,000 people.

Federal estimates suggest about 17% of enrollees across the country could lose coverage through the redetermination process — some because they now make too much money to qualify; others because they didn't complete the paperwork to renew their benefits.

That would work out to about 255,000 Minnesotans, although state officials say they aren't making projections because the estimates aren't certain.

U.S. Department of Health and Human Services Secretary Xavier Becerra said Thursday all states are facing a big challenge with these Medicaid redeterminations.

"I have a message for Minnesotans — it's a message I have for every American," Becerra said during a news conference in Minneapolis. "Please open your mail. Please read closely what it says. Please respond to that phone call, that text or that email, especially if it's coming from your county health representatives. Because they're probably trying to tell you: We don't want you to lose your health insurance coverage. And if you don't respond, you might."

Becerra noted that Minnesotans who no longer qualify for Medicaid can purchase subsidized private coverage through the MNsure health exchange.

Medicaid and related programs in Minnesota provide coverage primarily to lower-income and disabled state residents. The programs are administered through counties with support from the state Department of Human Services (DHS).

The prospect of re-enrolling 1.5 million people in coverage is "daunting," Jodi Harpstead, the DHS commissioner, said during the news conference. Minnesota faces an extra challenge, Harpstead added, because the state is one of just three in the nation where the redetermination process is handled via paper rather than electronically.

"We have underfunded our IT systems over the decades," Harpstead said.

The state and counties are implementing new initiatives, however, to help maintain coverage for people who qualify, Harpstead said.

When the first subset of enrollees goes through the renewal process in July, some amount of disenrollment is expected, said Rep. Mohamud Noor, DFL-Minneapolis.

"The goal is to make sure ... that everyone who's eligible continues to receive their coverage," Noor said.

DHS estimates that 15% to 25% of people currently enrolled in Medical Assistance and MinnesotaCare — the largest Medicaid programs in the state — may lose coverage when renewals resume. However, initial estimates from DHS suggest that about 30% to 50% will likely re-enroll within a short period of time because they're still eligible.

Before the pandemic, it was common for many enrollees in the public health insurance programs to transition in and out of coverage with their annual renewals.

"Some enrollees will lose their Medical Assistance and MinnesotaCare coverage when renewals resume because their circumstances have improved and they no longer meet the program eligibility requirements," DHS said in background materials about the renewal process. "However, some portion of enrollees will likely remain eligible for coverage and meet all of the requirements to keep it, but will lose their coverage due to barriers in the renewal process, including failure to receive notices or return paperwork, paperwork getting lost, and other issues unrelated to their actual eligibility status."

DHS says it's working to minimize administrative barriers with renewals.

The state and private health plans want those who no longer qualify for Medicaid to consider buying subsidized coverage from insurance companies that sell through the MNsure health exchange. That includes Minneapolis-based UCare, which also is an HMO for those who qualify for Medical Assistance or MinnesotaCare.

"Our goal is to help members maintain their coverage by providing timely reminders, accurate information and application assistance when needed," UCare said in a statement. "We will also support MNsure individual and family plan enrollment for members no longer eligible for Medical Assistance."

About 87,000 enrollees are due for renewal in July. The state say it's relying on paper-based renewals because a new online portal that's under development isn't yet ready.