Unsheltered people are losing Medicaid in redetermination mix-ups

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Unsheltered people are losing Medicaid in redetermination mix-ups
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On a cold February morning at the Flathead Warming Center, Tashya Evans waited for help with her Medicaid application as others at the shelter got ready for the day in this northwestern Montana city.

Apr 23 2024KFF Health News Evans said she lost Medicaid coverage in September because she hadn't received paperwork after moving from Great Falls, Montana. She has had to forgo the blood pressure medication she can no longer pay for since losing coverage. She has also had to put off needed dental work.

As other guests filtered out of the shelter that February morning, Evans sat down in a spare office with an application counselor from Greater Valley Health Clinic, which serves much of the homeless population here, and recounted her struggle to reenroll. There's no public data on how many unhoused people in Montana or nationwide have lost Medicaid, but homeless service providers and experts say it's a big problem.

Federal health officials have warned Montana and some other conservative states against disenrolling high rates of people for technicalities, also known as procedural disenrollment. They also warned states about unreasonable barriers to accessing help, such as long hold times on help lines. The Centers for Medicare & Medicaid Services said if states don't reduce the rate of procedural disenrollments, the agency could force them to halt their redetermination process altogether.

Margot Kushel, a physician and a homeless researcher at the University of California-San Francisco, said it may not seem like a big deal to fill out paperwork. But, she said, "put yourself in the position of an elder experiencing homelessness," especially those without access to a computer, phone, or car.

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