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Since April of this year, 8,268 Whatcom County-based Medicaid (Apple Health) patients — equivalent to more than double the seating capacity of Bellingham’s Civic Stadium — have lost healthcare coverage. This includes 11% of Medicaid members at Unity Care NW, a local federally qualified nonprofit health center that provides services regardless of a patient’s ability to pay.

While all Medicaid enrollees are usually required to reapply annually, Unity Care NW CEO Jodi Joyce says people enjoyed a pandemic-related pause in those redeterminations. When that pause ended this spring, many Washington State residents suddenly found themselves without coverage.  

While the reasons for that varied widely, statewide data reveals that the vast majority lost coverage for what Joyce calls ‘procedural reasons’: in short, because redetermination documents weren’t completed.

In some cases, that’s because people were confused about how to complete the paperwork. Others, either assuming or knowing they’d no longer qualify for Medicaid, didn’t bother to re-apply. Unfortunately, some people lost coverage because documents were sent to out-of-date addresses and emails, and they didn’t know until it was too late.

Even worse, Joyce says that while the state committed to ensuring children six and younger remained enrolled in Medicaid, its system could not meet that goal. As a result, children lost coverage just like everyone else, and because the state lacks an automated reenrollment process, they are slowly being reenrolled by hand.

“If you’re a parent and you’ve been told your child no longer has insurance, you’re going to be scared to go to the pediatrician,” says Joyce.

Everyone who has an Apple Health plan will have a Blue ProviderOne card and will need to file renewal paper annually to stay enrolled. This can be done online at www.wahealthplanfinder.org. Photo courtesy Unity Care NW

The Effects of Loss

Nicole Fields, Unity Care NW’s population health manager, says many may not yet be feeling the full effect of coverage loss.

The biggest concern is people avoiding care due to financial issues, or not realizing that providers like Unity Care NW can treat them even without coverage. Nationwide, one in five uninsured adults go without needed medical care due to cost, Fields says, with those who lose care less likely to receive both preventative care and services for major conditions and chronic diseases.

The loss of a service or program means providers are left to examine data for what’s no longer there, which can be hard to quantify, says Fields. But for those who’ve lost coverage, the effects often equate to difficult decisions.

“I expect we’ll see folks having to make a choice between receiving medical care and paying for essentials like food, childcare, and housing,” she says. “People may be less likely to come in for preventative care services like cancer screenings or for help managing their diabetes.”

With open enrollment for statewide healthcare plans ongoing through January 15th, anyone in need of health insurance can speak with an Enrollment Specialist at Unity Care NW for free by calling 360.788.2669 to better understand what they’re qualified for and get them on the path to coverage. Photo courtesy Unity Care NW

Reenrollment Jumpstart

Joyce says that although they’ve yet to see such scenarios play out among their patient base, Unity Care NW is closely watching for a drop in demand for services that would suggest otherwise.

In the meantime, Unity Care NW is serving as a communication vehicle to let people know reenrollment is happening. The organization has undertaken an extensive multimedia strategy to reach its patients, including frequently texting them to offer help with their applications.

And with open enrollment for statewide healthcare plans ongoing through January 15, this is the time to act.

“Now is a period when people can consider their current insurance coverage and look for other alternatives,” Joyce says. “Our outreach and enrollment team can help people navigate what their choices are.”

Unity Care NW’s phenomenal team of Insurance Enrollment Specialists can help patients understand what they’re qualified for and get them on the path to coverage, whether that’s Apple Health or another qualifying plan. Speaking with an Enrollment Specialist is free and walk-ins are available at Suite 107 of Unity Care NW’s Bellingham office, located at 1616 Cornwall Avenue. Those interested can also make appointments by calling 360.788.2669.

“It can feel super overwhelming to go through the process alone,” says Fields. “We’re here to help you. Our mission is to increase the years of healthy life in the people and communities we serve.”

In the meantime, those without coverage should not hesitate to get the care they need. Unity Care NW offers a sliding fee discount program to existing patients, which means they may be eligible for reduced costs based on income. That slide is as low as $25 for medical care.

“We’ll never turn someone away based on income,” Fields says.

While Joyce is optimistic that the Medicaid reenrollment process will slowly but surely sort itself out, she understands that people aren’t about to suddenly stop needing the care they’ve been getting.

“I don’t think that 12% fewer people in Whatcom County need Medicaid than they did in April of this year,” she says. “It’s clearly having some impact on the ability for individuals to seek care.”

Community members interested in supporting Unity Care NW in providing their sliding fee discount program to cover the costs of care for struggling patients, can contribute at UnityCareNW.org/Give.

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