About 40,000 people on MaineCare have not responded to a renewal request from the Maine Department of Health and Human Services during the unwinding period, which started in April 2023 and will end this October. (Photo by Getty Images)
As the state finalizes the process of determining which Mainers are still eligible for the state Medicaid program, tens of thousands remain at risk of losing their health coverage.
Of the more than 400,000 people enrolled in MaineCare, less than 10 percent have not yet renewed their affordable healthcare coverage since the state started Medicaid unwinding, the process of redetermining eligibility for every individual covered by MaineCare after pandemic-era expansions ended last year.
During the COVID-19 public health emergency, the federal government offered states extra benefits to keep people enrolled in Medicaid, which provides health coverage to millions of low-income adults, children, pregnant individuals, elderly adults and people with disabilities.
About 40,000 people on MaineCare have not responded to a renewal request from the Maine Department of Health and Human Services during the unwinding period, which started in April 2023 and will end this October.
Maine manages to retain most Medicaid enrollees even as pandemic-era protections end
While they have maintained MaineCare coverage throughout the unwinding process, if they are not determined eligible through an automatic check of their income and other categories, and continue to be unresponsive, they may soon find themselves without coverage.
While the majority of people with pending eligibility decisions are white, there are racial disparities in the rates of unwinding, according to a Maine DHHS report from August. Of the people who receive MaineCare and identify as Black, 12 percent — or 2,360 people — have not been determined eligible for continued coverage yet, which is higher than any other racial group.
The same is true for people whose primary language is French. Of the original unwinding population who reported French as their primary language, nearly 16 percent have not yet renewed their coverage.
Younger adults, between 21 and 49 years old, make up a majority of people whose eligibility is yet to be determined.
“Relative to other members of the unwinding population, the remaining unwinding population has been more difficult to reach throughout the unwinding process, as evidenced by their failure to return multiple requests for renewal,” the report says.
Courtney Cowan, founder of Maine Medicare Solutions, an independent consulting agency helping Mainers with affordable and marketplace health coverage, said Maine’s unwinding, which has seen more than 300,000 people retain coverage, has been going well due to the department’s outreach efforts.
“I think the remainder that have not re-enrolled or requalified, they understand that the writing’s on the wall,” she said. “I think they’re not doing that purposely because they were put on during the pandemic, and understand that they’re not going to be redetermined to be eligible moving forward. So of those that have not responded yet, it’s probably because they’re assuming that they will not be requalified.”
Republican state Senator Marianne Moore of Washington, who is on the Health and Human Services Committee, said while the unwinding process has been going well so far, the state’s goal should be making sure everyone on MaineCare is eligible to receive coverage.
“I don’t know that I would set a goal of saying I want to retain 70 percent of the people on MaineCare,” Moore said. “I want to make sure that those that are on MaineCare are eligible for MaineCare and that we’re taking care of our people.”
For example, she said in some cases people may have left the state and are still covered by MaineCare because the state wasn’t able to remove them from its roster.
For the 40,000 people whose eligibility has yet to be determined, Moore urged them to respond to communications and ads “so that our numbers will be accurate, and we’ll know where we stand and where we need to go from here,” she said.
DHHS has prioritized outreach to keep Mainers informed and covered
The department is working on several outreach methods to try and reach people, including offering information in different languages, email and snail mail communications, ads on TV and radio stations, and advertising at gas stations and public transportation hubs, according to Jackie Farwell, spokesperson for Maine DHHS.
The department also added funds to contracts with fifteen community-based organizations to support outreach related to the unwinding, and assistance in navigating renewal and transitions, she said in an email.
Finally, the department has worked with other state agencies, health care providers, and employers to communicate with people. For example, a flyer about Medicaid coverage will be included in the Department of Education’s Back to School “virtual backpack,” and unwinding information will be made available on Department of Labor sites for employers and job seekers, Farwell said.
“The next few months will be a critical period, as the department begins the process of determining eligibility for the remaining population that has not yet responded to their renewal requests,” she said.
“Continued outreach efforts are focused on bridging this communication gap. As the final three months of the ‘unwinding’ period get under way, DHHS is prioritizing a comprehensive outreach effort to ensure MaineCare members know they need to connect with the Department to continue their coverage.”
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