Experts discuss Medicaid coverage landscape as they prepare for end of PHE


Shane Ersland


Although it is still unclear exactly when the public health emergency (PHE) will end, Washington health coverage professionals are working hard to prepare for Medicaid redeterminations and new procurements.


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Anthony Woods, Aaron Wilson, and Charissa Fotinos, MD, discussed preparations they are making to help Washingtonians retain their health coverage at the 2022 Inland Northwest State of Reform Health Policy Conference.

The PHE is currently scheduled to end on Oct. 13th but is expected to be extended once again, into 2023. Fotinos, the state’s Medicaid Director, said the Washington State Health Care Authority (HCA) expects it to end in January, following discussions HCA has previously had with federal sources. She said HCA added about 400,000 people to Medicaid during the COVID-19 pandemic.

“We’ll review people’s eligibility, see if they are still enrolled, and if [they’re] eligible, keep them on Medicaid,” Fotinos said. “And, if not, refer them either to a qualified health plan or help support the transition to whatever product they feel is best for them. We are working closely with our plan partners and our community is hearing from us as well. Our bottom line goal is to not have anybody drop coverage.”

While the goal is to keep everyone covered, the HCA knows there will be some coverage gaps. Fotinos said she anticipates a 5% increase in the state’s number of uninsured people. 

“But we’ll see,” Fotinos said. “The legislature instructed us to develop an Apple Health program for folks who are not federally qualified for benefits. Hopefully that will fill some of that gap. But that remains to be seen. The thing to highlight, from our perspective, is this is a big project. We haven’t done anything this big since the Affordable Care Act.”

The HCA added many new employees to help with the process, Fotinos said.

“They’ve never had to do any of these eligibility redeterminations, so we’ll be training lots of new staff, supporting our legal services to be able to manage appeals that people make,” Fotinos said. “[We’re] trying to make it barrier free for folks, trying to make minimum work for folks who are trying to stay covered or get covered.”

Woods, President and CEO of Amerigroup Washington, said the organization has been working to update customers’ information to help them retain coverage and keep them up to date on policy requirements. 

“It’s imperative that we work with not just health care authorities, but also our providers,” Woods said. “We have about 100,000 patients in the northwest, and about 60,000 patients are Medicaid beneficiaries right now. Our work right now 100% is capturing every single person that walks in the door, their updated contact information, email, [and] mailing address.”

Wilson, CEO of the federally qualified health center CHAS Health, said the Medicaid eligibility expansion that occurred during the pandemic allowed the organization to see its uninsured customer rates go from 40% to under 10%.

“From our perspective, Medicaid expansion has been an absolute triumph really, for a lot of the folks who are uninsured,” Wilson said. “These are folks that have been able to engage with health care on a long-term basis, not upon an episodic or just isolated incident. These are folks engaged in health care services. So as we look at the future, I look at sort of the immediate issue of redetermination, but then we also look at longer-term issues and capacity.”

Early in the pandemic, the HCA struggled to reach marginalized communities, Fotinos said. 

“And those are some of the most vulnerable folks from income status [to] housing,” Fotinos said. “I think one of the things that really matters most is how we approach our rural connection, our rural strategy. And that’s one of the things we’re exploring and talking with rural providers [about], what’s the best approach? We have to go through this redetermination process, and that’s going to impact everybody. But the other issue is adequate capacity and access for the population.”