Millions of New Yorkers May Lose Access to Healthcare Due to Public Health Emergency Expiration

In 2019, Over 7.4 million New Yorkers were enrolled in the Department of Health (DOH) Medicaid Essential Plan and Child Health Plus (CHP). Healthfirst — one of the largest not-for-profit health insurance companies — covers over 1.8 million members.

Since the COVID-19 Public Health Emergency (PHE) has ended, New York State announced that auto-renewals would end on June 30, 2023, putting millions of New Yorkers in jeopardy of losing their health insurance.

Errol Pierre, senior vice president of state programs at Healthfirst, told NurseJournal that a challenge it faces is educating members about when and how they must renew their plans.

“One of the main challenges with the end of auto-renewals is a potential lack of awareness of the upcoming change and the actual process of renewing,” Pierre said.

In December 2022, The Robert Wood Johnson Foundation conducted a survey to find out how aware Medicaid enrollees were that they might lose their Medicaid coverage after the end of PHE. According to the survey, 62% of adults with family Medicaid enrollment reported hearing nothing about the end of automatic renewals.

With the end of the COVID-19 PHE on May 11, 2023, legislation that allowed certain flexibilities and waivers returned to pre-pandemic or modified regulations.

The end of the PHE affects coverage, cost and access to diagnostic procedures, vaccines, telehealth and home care services. It also affects healthcare coverage and affordability for millions of Americans.

As part of the emergency plan, New Yorkers enrolled in government programs like Healthfirst have had their Medicaid coverage automatically renewed yearly for the past three years. Automatic renewal meant members in plans like Medicaid, Essential Plan (EP), Child Health Plus “CHPlus,” Personal Wellness Plan (HARP) and dual Medicare plans did not have to recertify their eligibility each year and continued their coverage.

But with the end of the PHE, so is the end of automatic renewal.

“If members do not renew their insurance, they may lose benefits and services that are essential to their optimal health,” says Jessica Hensler, RN, a nurse care manager for Healthfirst.

Without health insurance, individuals are at risk for numerous health issues and healthcare costs that can be avoided with adequate coverage. Renewal of healthcare coverage also avoids gaps in care.

“It is important to complete the redetermination process as soon as possible to ensure Healthfirst member’s healthcare coverage is maintained,” Pierre says.

If individuals fail to complete the redetermination process or the state determines they no longer qualify for Medicaid, their coverage will be terminated.

Congress and the Biden Administration are reexamining many PHE COVID-19 flexibilities because of the added healthcare benefits like low cost and accessibility for individuals. For example, telehealth Medicaid coverage will last until 2024 due to increased demand.

New Yorkers need to know what to expect and how to keep their health coverage as the New York State of Health returns to its regular renewal processes. According to the New York State Public Health Emergency Unwind Dashboard, renewal notices have been going out since early spring. The renewal notices will continue each month until every cohort- renewal cycle of enrollees- redetermines their eligibility.

The Medicaid recertification process might also impact older adults with a Medicare Advantage Plan.

“They, too, should check to see if they need to act to keep their coverage intact,” Pierre pointed out.

There are actions individuals can take to maintain their Medicaid eligibility.

“If you no longer qualify for Medicaid and are in need of a new health insurance plan for you or your family, Healthfirst is here to help,” Pierre told NurseJournal.

To renew, individuals should follow two simple steps:

Medicaid members can log into their account at nystateofhealth.ny.gov or call 1-855-355-5777 regarding their health insurance plan.

When it is time to renew your health insurance, you will receive notice from the NY State of Health, your county’s Local Department of Social Services, or the New York City Human Resources Administration. This letter will let you know when to renew and what to do. Follow the instructions right away so you don’t lose coverage.

This year, there will be a statewide check of eligible individuals in every state enrolled in the program, Pierre tells us.

“That’s about 84 million people across the country. Of those, nearly 8 million are New Yorkers,” he said.

To bring awareness and aid to New Yorkers, Healthfirst developed a campaign to help avoid gaps in coverage. They are helping through:

Healthfirst also partners with local health providers and community organizations to spread the word.

Healthcare workers and care managers like Hensler can get involved by assisting members and helping them find the appropriate resources. Resources include:

“At Healthfirst, we assist and advocate for our members to achieve optimal outcomes and receive support. Education is key in ensuring members are aware of their role in renewal,” Hensler said.

Nurses can encourage their patients to keep their contact information updated and educate their communities about the importance of renewing their coverage.

“Nurses, use your cultural competency to reach out to educate vulnerable populations,” Pierre said.

Due to the end of the PHE, Healthfirst encourages healthcare workers to stay informed about the changes. Healthcare workers and nurses involved in community outreach can also empower communities by educating them about their options and renewal dates.

For non-New York residents looking for information on eligibility in their state, learn more at medicaid.gov.