Health leaders discuss efforts to keep Arizonans covered during the Medicaid redetermination process

By

Hannah Saunders

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Health leaders discussed the state’s Medicaid redetermination process, and efforts aiming to ensure that as many residents retain healthcare coverage as possible, at the 2024 Arizona State of Reform Health Policy Conference. 

Jim Hammond, publisher and CEO of the Hertel Report, noted that, prior to the American Rescue Plan Act (ARPA), people with incomes above 400 percent of the federal poverty level were not eligible for premium tax credits.. Now, if health insurance costs surpass 8.5 percent of an individual’s income, they may qualify for subsidies. Hammond said about 80 percent of individuals in the Arizona marketplace are on subsidies. 

“Arizona’s marketplace shot up like crazy this past year. We went from 235,000 folks buying their plan on the marketplace in Arizona to 348. That’s a huge jump,” Hammond said. 

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Hammond noted that Arizona’s uninsured rate dropped from 17 percent in 2010 to a current rate of 10 percent.

“We’ve made an impact in the last 12 to 14 years in reducing the uninsured,” Hammond added. 

Patty Dennis, assistant director of the Arizona Health Care Cost Containment System (AHCCCS), said AHCCCS is helping the uninsured. During the redetermination period, AHCCCS renewed 2.5 million Arizonans. 

“All of our factual denials were referred to the marketplace, of course, because we have bilateral communication with the marketplace,” Dennis said. “With (the) unwinding, there’s a reconsideration period so members, if they don’t complete their renewals in 90 days, they come back. We had over 140,000 individuals do that, and of those, 59 percent were determined eligible and maintained coverage.” 

Dennis said the remaining 41 percent are considered factual discontinuances, and they were referred to the AHCCCS healthcare marketplace. She noted that AHCCCS does not refer individuals with procedural discontinuances to the marketplace. 

AHCCCS also implemented continuous coverage requirements for children for one year. Dennis also discussed new Centers for Medicare and Medicaid Services (CMS) initiatives.

“CMS just issued new rules related to streamlining Medicaid, and it’s three years (of) progressive implementation, so nothing happens overnight,” Dennis said. “There’s two, I think, really strong wins in that.” 

The move eliminated the requirement to apply for potential benefits, Dennis said. This flexibility was in place during the unwinding process, and CMS’ new rules state that applying for potential benefits can now be done in the initial application process. Eliminating the waiting period for KidsCare is another benefit of CMS’ new rules. Dennis said children no longer have to wait for proof they lack healthcare insurance, and can instead get the coverage they need swiftly. 

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