Medicaid and income changes in 2022 (WA)

[less4success]

Is it true that during the COVID-19 Public Health Emergency you can't be kicked off Medicaid even if your income increases?

Context:

I was approved for and have been on (income-based/ACA) Medicaid in WA for more than a year. My spouse started a new job recently that pushed our income up above 138% FPL (and above 200%, in case that's relevant).

I updated my income info with my state and the (automated) result said I'm ineligible for Medicaid, so it invited me to shop for a plan on the marketplace.

My understanding is that the COVID PHE won't end in 2022 and I shouldn't be kicked off of Medicaid in 2022, despite the income increase. If I'm right, then shopping for a marketplace plan is a really bad idea because that means I would not be eligible for tax credits either (because I have other insurance, i.e. Medicaid).

So... why is it trying to get me to sign up for unnecessary and unsubsidized insurance? Is my understanding incorrect?

I'll have to wait until tomorrow to get a direct answer from marketplace support. For what it's worth, I described my situation to a support agent today to resolve a separate issue and they didn't bring up the PHE (although I didn't directly ask about my eligibility--I was asking how to enter my income correctly).

[Sibley]

Medicaid is state specific. What state are you in?

[less4success]

Washington. This is what I was looking at:

https://www.hca.wa.gov/about-hca/news/announcements/apple-health-coverage-will-continue-during-public-health-emergency

But it doesn’t at all match what the WA Health Plan Finder shows me.

Specifically, this quote makes it sound like what happened to me shouldn’t have happened:

Current Washington Apple Health (Medicaid) clients will not lose their coverage during the PHE unless they don’t meet residency, citizenship or immigration requirements. Clients should continue to report changes in income, household members, and contact information.

If you have Apple Health coverage, you will not lose your coverage for reporting a change during the PHE.

[jim555]

The PHE was just extended through January 2023.  No one loses coverage while the PHE is on.  You don't need a Marketplace policy.  They will redetermine everyone when the PHE ends, but that may take up to a year to complete.

You can make any amount of income and not lose coverage.  Even if their system is saying you are no longer eligible you will not lose coverage.

[less4success]

Thanks! That matches my understanding.

(Removed rant)

[less4success]

Just got confirmation that the marketplace web site doesn’t take the PHE into account, and I shouldn’t actually lose coverage. I’m not sure if everyone has to call in to get Medicaid reinstated like me or what. I’m fairly annoyed, but I guess it’s saving me a couple hundred a month in health insurance premiums, so I really shouldn’t be complaining.

[jim555]

Just got confirmation that the marketplace web site doesn’t take the PHE into account, and I shouldn’t actually lose coverage. I’m not sure if everyone has to call in to get Medicaid reinstated like me or what. I’m fairly annoyed, but I guess it’s saving me a couple hundred a month in health insurance premiums, so I really shouldn’t be complaining.

They shouldn't be dropping anyone now.  Kind of surprised they would drop you.

[less4success]

Just got confirmation that the marketplace web site doesn’t take the PHE into account, and I shouldn’t actually lose coverage. I’m not sure if everyone has to call in to get Medicaid reinstated like me or what. I’m fairly annoyed, but I guess it’s saving me a couple hundred a month in health insurance premiums, so I really shouldn’t be complaining.

They shouldn't be dropping anyone now.  Kind of surprised they would drop you.

I should have asked them what would have happened if I hadn't called. It's possible that once it got to the point of actually dropping me someone would have noticed and fixed it. I literally had just updated my income info yesterday (after cashing the first paycheck), so it's not like I got a physical piece of mail saying I'd lose coverage or anything like that.

Honestly, I thought this far into the PHE they would have this system sorted out, but apparently not. One comment from the marketplace support person I talked to made it sound like the state healthcare authority is responsible for the PHE details and the marketplace web site is kind of oblivious to the whole thing.

I'm still curious how many people updated their income as required and then unnecessarily bought health insurance plans from the marketplace because that's what the web site guided them to do...

[Sibley]

Just got confirmation that the marketplace web site doesn’t take the PHE into account, and I shouldn’t actually lose coverage. I’m not sure if everyone has to call in to get Medicaid reinstated like me or what. I’m fairly annoyed, but I guess it’s saving me a couple hundred a month in health insurance premiums, so I really shouldn’t be complaining.

They shouldn't be dropping anyone now.  Kind of surprised they would drop you.

I should have asked them what would have happened if I hadn't called. It's possible that once it got to the point of actually dropping me someone would have noticed and fixed it. I literally had just updated my income info yesterday (after cashing the first paycheck), so it's not like I got a physical piece of mail saying I'd lose coverage or anything like that.

Honestly, I thought this far into the PHE they would have this system sorted out, but apparently not. One comment from the marketplace support person I talked to made it sound like the state healthcare authority is responsible for the PHE details and the marketplace web site is kind of oblivious to the whole thing.

I'm still curious how many people updated their income as required and then unnecessarily bought health insurance plans from the marketplace because that's what the web site guided them to do...

It is actually quite possible that the website/systems are outdated. The IRS is using systems from the 60s if I remember right, your state having inadequate tech wouldn't be surprising at all.

[jim555]

Just got confirmation that the marketplace web site doesn’t take the PHE into account, and I shouldn’t actually lose coverage. I’m not sure if everyone has to call in to get Medicaid reinstated like me or what. I’m fairly annoyed, but I guess it’s saving me a couple hundred a month in health insurance premiums, so I really shouldn’t be complaining.

They shouldn't be dropping anyone now.  Kind of surprised they would drop you.

I should have asked them what would have happened if I hadn't called. It's possible that once it got to the point of actually dropping me someone would have noticed and fixed it. I literally had just updated my income info yesterday (after cashing the first paycheck), so it's not like I got a physical piece of mail saying I'd lose coverage or anything like that.

Honestly, I thought this far into the PHE they would have this system sorted out, but apparently not. One comment from the marketplace support person I talked to made it sound like the state healthcare authority is responsible for the PHE details and the marketplace web site is kind of oblivious to the whole thing.

I'm still curious how many people updated their income as required and then unnecessarily bought health insurance plans from the marketplace because that's what the web site guided them to do...

I doubt it would have let you complete anything since having Medicaid and Marketplace together is not allowed.

[jim555]

It is actually quite possible that the website/systems are outdated. The IRS is using systems from the 60s if I remember right, your state having inadequate tech wouldn't be surprising at all.

Depends on the state.  NY has it fully integrated and seamless as far as ACA / Medicaid and NY runs the site. 

The PHE wasn't programmed because it is highly unusual and of unknown duration so they aren't going to be updating systems and spending money for it.

[less4success]

Just got confirmation that the marketplace web site doesn’t take the PHE into account, and I shouldn’t actually lose coverage. I’m not sure if everyone has to call in to get Medicaid reinstated like me or what. I’m fairly annoyed, but I guess it’s saving me a couple hundred a month in health insurance premiums, so I really shouldn’t be complaining.

They shouldn't be dropping anyone now.  Kind of surprised they would drop you.

I should have asked them what would have happened if I hadn't called. It's possible that once it got to the point of actually dropping me someone would have noticed and fixed it. I literally had just updated my income info yesterday (after cashing the first paycheck), so it's not like I got a physical piece of mail saying I'd lose coverage or anything like that.

Honestly, I thought this far into the PHE they would have this system sorted out, but apparently not. One comment from the marketplace support person I talked to made it sound like the state healthcare authority is responsible for the PHE details and the marketplace web site is kind of oblivious to the whole thing.

I'm still curious how many people updated their income as required and then unnecessarily bought health insurance plans from the marketplace because that's what the web site guided them to do...

I doubt it would have let you complete anything since having Medicaid and Marketplace together is not allowed.

Actually, it did let me complete the process, because I forgot about the PHE and just followed the instructions and chose a plan (oops!). I cancelled the plan an hour later, and they’ve fixed my status now.