Native health expert says AHCCCS redeterminations will have significant impact on Native communities

Last Tuesday, the Arizona Health Care Cost Containment System (AHCCCS) announced that Medicaid and KidsCare disenrollments will soon begin again, with the federal public health emergency expected to expire late in the summer. Kim Russell, executive director of the Arizona Advisory Council on Indian Health Care, said these disenrollments would lead to a significant loss of coverage for Arizona’s native communities.

AHCCCS told State of Reform that as disenrollments have been suspended for most members during the federal public health emergency, AHCCCS will be required to reinstate disenrollment for individuals who no longer meet eligibility requirements or who do not respond to requests for more information to verify eligibility.

Russell estimates upwards of half of the American Indian population in Arizona to be on Medicaid. She emphasized the population’s heavy reliance on Medicaid, stating that at least 70% of third-party reimbursement comes from Medicaid for many tribal health systems.

“This payer source is very, very important to not only the community and our families and individuals who are eligible and on Medicaid, but to the system that provides the health care services to them,” she said.

AHCCCS said it is critical for covered individuals to respond to requests for information that the agency will send via mail, phone, and email. However, Russell says the two-week turnaround time from when the letter is sent to the time they need to return documents is unrealistic for many tribal populations, especially those in rural areas.

“Sometimes we live miles from [stores and the post office],” she said. “So, when we go into town, it’s a whole day event, and that happens maybe once a week. I get to check my mailbox every day, but for many of these rural communities, that’s not the [case].”

She also says the pandemic has deterred many members of native communities from checking their mail.

“A lot of our post offices are congregating sites, and we’ve been advised to not congregate,” said Russell. “So our concern is, once the letters are sent, when will [these individuals] realistically pick them up? And then in that time frame, how are they going to get all the documents that have been requested of them? Because of that, [we’re fearing it] will result in a lot of these redeterminations not even being considered.”

Russell added that AHCCCS’s online portals to upload documents are also often inaccessible for Native communities, as many tribal reservations are in rural areas that have trouble accessing the internet. She said increasing broadband access in the state’s rural areas is key to addressing this issue. 

AHCCCS has estimated that approximately 500,000 currently enrolled adults and children will need to complete a renewal to determine continued eligibility. They are encouraging their members to prepare for redetermination by updating their contact information on www.healthearizonaplus.gov, watching their mailboxes for a letter from AHCCCS, and responding to any requests from AHCCCS for more information.