Dive Brief:
- Many Medicaid enrollees don’t know about an upcoming policy change that will require them to report work, education or volunteer hours to stay covered, creating risks to their health and care, according to a survey published last week by the Health Management Academy.
- About 55% of beneficiaries are completely unaware of Medicaid work requirements — a policy enacted under the “Big Beautiful Bill” and set to go into effect in January. An additional 27% said they had heard something about work requirements, but were unsure of the details, according to the survey by the health executive professional group.
- Losing health insurance could have a significant impact on enrollees’ care. Around 37% said they would wait until a health concern became urgent and go to the emergency room if they lost coverage, and about 28% said they would use the emergency department for routine care.
Dive Insight:
The “Big Beautiful Bill” was signed into law nearly a year ago, setting in motion more than $1 trillion in cuts to federal healthcare spending and likely culling millions of people from their insurance coverage.
Medicaid took the brunt of the spending reductions. One of the biggest policy changes to the safety-net insurance program was the creation of work requirements, which mandate beneficiaries enrolled under Medicaid expansion log 80 hours of work, education or volunteer time each month to stay covered.
The work mandate is a significant undertaking for states, which have limited time to set up the infrastructure to oversee compliance and reach out to beneficiaries impacted by the policy. Just last week, the CMS released guidance on how to implement the work requirements, about six months before states are required to put them into effect.
Meanwhile, many Medicaid enrollees are unaware of the upcoming changes to their insurance, according to the HMA report, which surveyed nearly 2,000 beneficiaries this spring. Nearly half said they had heard “nothing at all” about the raft of Medicaid eligibility changes included in the “Big Beautiful Bill,” and another 32% reported they knew “a little.”
In one example, around 85% said they didn’t know that states will have to check eligibility for the safety-net insurance every six months.
And just 17% were aware of Medicaid work requirements, though awareness varied across states. In Oregon, 78% said they knew about the upcoming work mandates, while about half said they were aware in Nebraska — despite Nebraska rolling out the policy early in May.
Losing coverage will likely impact beneficiaries’ healthcare access, according to the survey. Sixty percent said they would stop routine doctor visits unless a situation became an emergency if they were disenrolled, while around 41% reported they would ration their existing medication. About 23% said they would become uninsured.
Cuts to Medicaid will also financially impact hospitals, especially facilities in rural areas or those that rely heavily on reimbursement from the safety-net insurance. If those providers shut down or cut back on services, many beneficiaries have few other options, according to the survey.
About 42% said they couldn’t travel any further than they currently do if their nearest hospital closed. Additionally, one-quarter of respondents with a chronic condition said a hospital closure would make managing their condition “much harder.”
