Pandemic rules ending for Wyoming Medicaid enrollment

For about three years, the state stopped reviewing whether Wyomingites enrolled on the Medicaid program were still eligible – but things are about to change.

As the Wyoming Department of Health prepares to resume the practice of reviewing people’s eligibility for Medicaid coverage, it is urging citizens to make sure their contact details are up to date.

“We just started sending renewal notices by mail to clients. We’ll be reviewing eligibility in the same manner as we did before the pandemic so it’s not something new,” said Lee Grossman, state Medicaid agent and Division of Healthcare Financing senior administrator with WDH.

“It’s important for clients to make sure we have their current contact information so they do not miss the renewal notice. Because of the pause, our clients have not received these notices by mail over the last three years. We know living situations may have changed during that time for many people.”

The law that placed a hold on determining eligibility was implemented at the start of the pandemic. The Families First Coronavirus Response Act included a requirement that Medicaid programs keep

people enrolled continuously until the end of the month in which the COVID-19 public health emergency ends.

The Consolidated Appropriations Act, 2023, was then signed into law at the end of last year, setting an end date of March 31 for that continuous enrollment provision. States may resume disenrolling people who no longer qualify for Medicaid in April, as part of the unwinding process.

The Office of the Assistant Secretary for Planning and Evaluation (ASPE) – advisor to the Secretary of Health and Human Services – estimates that up to 15 million people across the nation who are currently enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) will lose coverage as the provision expires – 17.4% of people who are currently enrolled.

ASPE projects that 8.2 million of these people will leave the program due to loss of eligibility, and 6.8 million will lose coverage despite still being eligible due to “administrative churning”.

Other common reasons people lose coverage include reaching adulthood, which means they are no longer eligible for coverage as a child; an increase in personal and family income; a health status change; or moving to another state.

Almost a third of people predicted to lose eligibility are expected to qualify for premium tax credits on the federal Health Insurance Marketplace. Some children may also be moved from Wyoming Medicaid to the WDH Kid Care CHIP program, which has different income guidelines.

Meanwhile, WDH is hoping to ensure that as many people as possible who are still eligible for Medicaid are able to remain on the program.

“We do not want covered individuals to lose coverage because we don’t have their current address and will be making the best efforts we can to reach people,” Grossman said.

WDH will be sending a certain percentage of renewal notices by mail to current enrollees each month for the next year.

Not all clients will receive their renewal notices at the same time. The effort will continue on a standard, ongoing basis in future years.

“We’ll be renewing people who are still eligible for Wyoming Medicaid services while we also end coverage for those who are no longer eligible,” Grossman said. “This effort is something we’ve been expecting and planning to accomplish for quite some time and helps ensure state and federal resources are used appropriately.”

Having a low income does not automatically qualify people for Wyoming Medicaid. While most people on Medicaid are indeed low-income, people must also fall into certain categories based on age or health status.

Update your contact information online at www.wesystem.wyo.gov or by calling 1-855-294-2127. You can also email [email protected], including your full name and date of birth or case number.