My daughter is one of the nearly 60,000 people who was disenrolled from Medicaid in New Mexico this year.
The disenrollment is happening nationwide following the end of the Families First Coronavirus Response Act’s continuous enrollment requirements enacted by the federal government at the beginning of the COVID-19 pandemic. It’s part of a process known as the “Medicaid unwinding.”
In Montana, where I lived for eight years before returning home to New Mexico, and where I depended on Medicaid coverage for myself and my kids, 34,204 people have been disenrolled. It is worth noting that Montana’s population is half that of New Mexico’s.
My daughter is among a majority of people who still qualify for Medicaid, but who have been ejected from the system anyway with little-to-no warning and not enough time for recertifying employment information. In my daughter’s case, the paperwork I received in the mail in August indicated that I had until the end of October to update my information. Since I had just started a new job, I needed to wait until early September to have the pay stubs needed. But in early September, I received notification from the New Mexico Health and Human Services Department (NMHHSD) that my daughter had been dropped from Medicaid.
A byzantine application process
Although I have reapplied to get my daughter back on New Mexico Medicaid, the process is overwhelmingly byzantine and outdated. Wait times for paperwork review can take up to two months in some cases, if documents are reviewed at all. Noticing that my kids’ names were spelled incorrectly on their Medicaid cards in the summer of 2021, I submitted their birth certificates and Social Security cards as directed by a woman I contacted at NMHHSD. When I log into the online platform, I can see the documents still sitting there, but two years later the names still have not been corrected.
This is just one of many examples of the frustrating obstacles and bureaucratic mazes my family and many others have been forced to navigate during the Medicaid unwinding. Unfortunately, it’s not altogether new for us, as my family has been through similar experiences countless times as part of the Medicaid application and recertification process in both New Mexico and Montana for the entirety of my kids’ lives. My kids are now 20 and 16.
Listening to an NPR report about the struggles Montanans are facing with disenrollment from Medicaid in recent months gave me a stress headache because they played the audio of the pre-recorded messages you get when you call the Montana Department of Public Health and Human Services (MDPHHS).
“You have reached the Montana Public Assistance Helpline, to speak with someone, press zero. Did you know that you can request a callback so you don’t have to wait on hold?”
It was a message I heard on repeat multiple times a year every time I had to re-certify or contact them about an error that had been made. In the NPR story, they claim the average wait time to get through to a real person at the Montana Department of Health is 42 minutes. If this is accurate—it’s an improvement on my experience. I was often on hold for up to three hours. The option to receive a call-back was hit-or-miss. Sometimes I got a call back and sometimes I didn’t.
“It’s a huge concern to us”
Continuous enrollment in Medicaid ended on March 31 of this year. But disenrollment is happening at such a high rate that at the beginning of August, the federal agency Centers for Medicare & Medicaid Services (CMS) sent letters to every state Medicaid director to remind them that Medicaid must remain accessible to all who qualify. Montana and New Mexico (along with Rhode Island, Alaska, and Florida) are among the five states singled out for the highest rates of disenrollment and the biggest barriers to enrollment or re-enrollment, including long wait times on the phone and mail problems.
Gabriella Rivera, policy and communications director for Health Action New Mexico, said she recently heard a report of an eligible family with three kids who received three different notices regarding their renewal status–one received an extension, one received a full year renewal, and one was disenrolled.
“That kind of thing is really disheartening because we don’t exactly know what’s going on. The only thing HSD can really say for it is that they’re not staffed sufficiently,” Rivera says. “Health Action New Mexico is dedicated to ensuring quality affordable health care for all New Mexicans because it’s a state with 50% of the population on Medicaid. It’s the predominant health care system here. So it’s a huge concern to us.”
Across the country, 7.5 million people have lost Medicaid coverage since April of this year when the Medicaid unwinding began. The reasons for loss of coverage vary widely across states because every state has its own system for handling eligibility and renewal. In Montana, I had to submit paperwork every six months and do an interview at least once a year—more if my income changed at all. In New Mexico, the requirements involve annual reporting and documentation, which is theoretically less time consuming, but in both places, calls, emails, and entered documents often seem to be disappearing into a void.
Medicaid access can be life or death
New Mexico ranks last in child well-being. This is due to a variety of factors, including New Mexico’s 24 percent child poverty rate (compared with the national average of 17 percent). It is also due to a 35 percent rate of unstable parent employment, poor health, and high child mortality. I know from past experience that families facing these kinds of stressors don’t have time to wait on the phone for three hours to ensure that their kids get on Medicaid—even though Medicaid may often be a matter of life and death.
I am fortunate that my daughter is currently in good health and up to date on her shots and doctors’ appointments. I can only hope that my paperwork is actually being processed and that she’ll be re-enrolled again soon before something comes up.
Rivera says 97% of the disenrollment from Medicaid in New Mexico have been procedural rather than based on changes in income eligibility. The New Mexico Center on Law and Poverty and Health Action New Mexico initiated conversations with HSD and Governor Michelle Lujan Grisham about pausing disenrollments until HSD staff can catch up on their workload.
“We think it would benefit everyone and that we should just take a step back and slow the process down,” Rivera says. “It’s an overwhelming, unprecedented situation. And we have new acting leadership in both the secretary of HSD and the head of Medicaid roles here that have had to jump in at probably the most chaotic time in the state’s Medicaid system’s history. We know there’s been effort, and there was a comprehensive plan put in place that we all thought was okay–but it’s not translating to keeping New Mexicans covered.”
According to Rivera, the New Mexico Center on Law and Poverty is drafting a letter for organizations across the state to send to HSD and the governor requesting a pause on disenrollment within the parameters of federal regulation. The pause would ensure that families like mine are not disenrolled based on paperwork errors.
I will be watching closely to see what New Mexico is able to do. It is my hope that once disenrollment errors are corrected, states like New Mexico and Montana will work to update their systems to make them truly accessible. The lives of people across the country depend on the medications, tests, mental health care, and other needs that Medicaid covers for those who cannot afford healthcare by any other means.