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Most states aren’t set as much as attain Medicaid recipients by textual content : Photographs

Most states aren’t set as much as attain Medicaid recipients by textual content : Photographs

Most states aren't set up to reach Medicaid recipients by text : Shots

States should attain out to all Medicaid enrollees to tell them that their eligibility will must be reevaluated, however a lot of these states won’t be using one key technique: texting.

SOPA Photographs/SOPA Photographs/LightRocket by way of Getty Photographs


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SOPA Photographs/SOPA Photographs/LightRocket by way of Getty Photographs


States should attain out to all Medicaid enrollees to tell them that their eligibility will must be reevaluated, however a lot of these states won’t be using one key technique: texting.

SOPA Photographs/SOPA Photographs/LightRocket by way of Getty Photographs

West Virginia will use the U.S. Postal Service and a web-based account this summer time to attach with Medicaid enrollees concerning the anticipated finish of the COVID-19 public well being emergency, which is able to put many recipients liable to shedding their protection.

What West Virginia will not do is use a type of communication that is ubiquitous worldwide: textual content messaging.

“West Virginia is not set as much as textual content its members,” Allison Adler, the state’s Medicaid spokesperson, wrote to KHN in an e mail.

Certainly, most states’ Medicaid applications will not textual content enrollees regardless of the urgency to achieve them about renewing their protection. A Kaiser Household Basis report revealed in March discovered simply 11 states mentioned they’d use texting to alert Medicaid recipients concerning the finish of the COVID public well being emergency. In distinction, 33 states plan to make use of snail mail and a minimum of 20 will attain out with particular person or automated telephone calls.

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“It would not make any sense when texting is how most individuals talk right this moment,” mentioned Kinda Serafi, a associate with the consulting agency Manatt Well being.

State Medicaid businesses for months have been making ready for the top of the general public well being emergency. As a part of a COVID reduction legislation accredited in March 2020, Congress prohibited states from dropping anybody from Medicaid protection until they moved out of state in the course of the public well being emergency. When the emergency ends, state Medicaid officers should reevaluate every enrollee’s eligibility. Thousands and thousands of individuals may lose their protection in the event that they earn an excessive amount of or fail to offer the data wanted to confirm earnings or residency.

As of November 2021, about 86 million folks have been enrolled in Medicaid, in accordance with the Facilities for Medicare & Medicaid Providers. That is up from 71 million in February 2020, earlier than COVID started to ravage the nation.

West Virginia has greater than 600,000 Medicaid enrollees. Adler mentioned about 100,000 of them may lose their eligibility on the finish of the general public well being emergency as a result of both the state has decided they’re ineligible or they’ve failed to reply to requests that they replace their earnings data.

“It is irritating that texting is a way to satisfy folks the place they’re and that this has not been picked up extra by states,” mentioned Jennifer Wagner, director of Medicaid eligibility and enrollment for the Heart on Funds and Coverage Priorities, a Washington-based analysis group.

The issue with counting on the Postal Service is {that a} letter can get hidden in “junk” mail or can fail to achieve individuals who have moved or are homeless, Serafi mentioned. And e mail, if folks have an account, can find yourself in spam folders, she famous.

In distinction, surveys present lower-income Individuals are simply as probably to have smartphones and cellphones as the final inhabitants. And most of the people repeatedly use texting.

In Michigan, Medicaid officers began utilizing textual content messaging to speak with enrollees in 2020 after constructing a system with the assistance of federal COVID reduction funding. They mentioned texting is a cheap technique to attain enrollees.

“It prices us 2 cents per textual content message, which is extremely low cost,” mentioned Steph White, an enrollment coordinator for the Michigan Division of Well being and Human Providers. “It is a fantastic return on funding.”

CMS officers have informed states they need to contemplate texting, together with different communication strategies, when making an attempt to achieve enrollees on the finish of the general public well being emergency. However many states haven’t got the know-how or details about enrollees to do it.

Efforts so as to add texting additionally face authorized limitations, together with a federal legislation that bars texting folks with out their consent. The Federal Communications Fee dominated in 2021 that state businesses are exempt from the legislation, however whether or not counties that deal with Medicaid duties for some states and Medicaid managed-care organizations that work in additional than 40 states are exempt as properly is unclear, mentioned Matt Salo, government director of the Nationwide Affiliation of Medicaid Administrators.

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CMS spokesperson Beth Lynk mentioned the company is making an attempt to determine how Medicaid businesses, counties and well being plans can textual content enrollees inside the constraints of federal legislation.

A number of states informed KHN that Medicaid well being plans will likely be serving to join with enrollees and that they count on the plans to make use of textual content messaging. However the requirement to get consent from enrollees earlier than texting may restrict that effort.

That is the scenario in Virginia, the place solely about 30,000 Medicaid enrollees — out of greater than 1,000,000 — have agreed to obtain textual content messages straight from the state, mentioned spokesperson Christina Nuckols.

In an effort to spice up that quantity, the state plans to ask enrollees in the event that they need to choose out of receiving textual content messages, quite than ask them to choose in, she mentioned. This fashion, enrollees would contact the state provided that they do not need to be texted. The state is reviewing its authorized choices to make that occur, she mentioned.

In the meantime, Nuckols added, the state expects Medicaid well being plans to contact enrollees about updating their contact data. 4 of Virginia’s six Medicaid plans, which serve the majority of the state’s enrollees, have permission to textual content about 316,000, she mentioned.

Craig Kennedy, CEO of Medicaid Well being Plans of America, a commerce group, mentioned that almost all plans are utilizing texting, and that Medicaid officers will use a number of methods to attach with enrollees. “I don’t see this as a detriment, that states aren’t texting details about reenrollment,” he mentioned. “I do know we will likely be serving to with that.”

California officers in March directed Medicaid well being plans to make use of quite a lot of communication strategies, together with texting, to make sure that members can retain protection if they continue to be eligible. The officers informed well being plans they might ask for consent by an preliminary textual content.

California officers say additionally they plan to ask enrollees for consent to be texted on the enrollment software, though federal approval for the change shouldn’t be anticipated till the autumn.

A number of state Medicaid applications have experimented in recent times with pilot applications that included texting enrollees.

In 2019, Louisiana labored with the nonprofit group Code for America to ship textual content messages that reminded folks about renewing protection and offering earnings data for verification. In contrast with conventional communication strategies, the texts led to a 67% improve in enrollees being renewed for protection and a 56% improve in enrollees verifying their earnings in response to inquiries, mentioned Medicaid spokesperson Alyson Neel.

Nonetheless, the state is not planning to textual content Medicaid enrollees concerning the finish of the general public well being emergency as a result of it hasn’t arrange a system for that. “Medicaid has not but been in a position to implement a textual content messaging system of its personal on account of different company priorities,” Neel mentioned.

KHN (Kaiser Well being Information) is a nationwide newsroom that produces in-depth journalism about well being points. It’s an editorially unbiased working program of KFF (Kaiser Household Basis).

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