The Maine Department of Health and Human Services began “unwinding” MaineCare’s 400,000-plus enrollment two months ago by “redetermining” all recipients’ eligibility for coverage, according to a July 28 press release. Eligibility reviews were “temporarily waived” by the federal government from March of 2020 until April of 2023 “as part of the response to the COVID-19 pandemic.”
So far, 3,000 individuals have been deemed ineligible and were subsequently unenrolled from the program. 24,769 people were cleared for renewal.
Back in 2020, the Maine DHHS halted eligibility checks in light of the Families First Coronavirus Response Act (FFCRA) passed by the federal government. Under this law, state governments were required to continue providing benefits to anyone who was enrolled in a Medicaid program at the start of the pandemic, as well as to provide benefits to anyone who enrolled in the program during the pandemic.
If a state opted to not abide by these guidelines, it would become ineligible to receive the 6.2 percent funding increase also included in the legislation.
The eligibility check waiver was originally set to last until the COVID-19 pandemic was no longer classified as a public health emergency by the federal government. Congress later de-linked this from the public health emergency declaration, stating the required waiver on eligibility checks would expire on March 31 of this year.
According to KFF estimates, anywhere from 8 to 24 million current Medicaid enrollees are expected to be unenrolled from the program once subjected to an eligibility check.
As part of the efforts made by the Maine DHHS to restart eligibility checks for MaineCare, the Department is rolling out a new “passive renewal” system beginning in August wherein a person’s coverage will automatically be renewed if they are found to be eligible by the Department.
This is a departure from the Department’s previous policy wherein individuals had to manually file for renewal or else experience a lapse in coverage.
The Department stated that they will be also applying the new “passive renewal” system retroactively to those who had renewal dates in May, June, and July. Therefore, the Department reports that no one has been unenrolled from MaineCare due to “procedural” reasons.
The Maine DHHS will be continuing to reevaluate the eligibility of MaineCare recipients well into next year.
According to the Maine DHHS, data will be available soon regarding the number of individuals who were removed from MaineCare due to ineligibility but subsequently enrolled in alternative health insurance through the CoverME marketplace.
The Maine DHHS stated in its press release that estimates suggest the vast majority of those who are deemed ineligible for MaineCare will qualify for insurance either through their employer or a federal- or state-based marketplace.
Read the Full Maine DHHS Press Release
Read the Federal Government’s Full Explanation of the FFCRA