Alabamians who received Medicaid during COVID-19 may be losing health coverage this spring as pandemic safeguards end.

Pandemic-era protections that stopped states from dropping ineligible people from Medicaid rolls will expire starting April of this year. About 61,000 Alabamians are expected to lose Medicaid coverage by June of 2024 as a result, according to a report by the Robert Wood Johnson Foundation and the Urban Institute.

States can begin dropping people who are no longer eligible due to a change in income, if they have failed to update the state on a changed address or for other reasons as soon as April of 2023. That continues through June of 2024.

Jennifer Harris, health policy advocate for the non-profit advocacy group Alabama Arise, said she is worried that some people who might not realize their insurance is ending or that they need to take steps to prevent losing their Medicaid will fall through the cracks during the process.

“A lot of people may not be familiar with Medicaid eligibility and how Medicaid determines eligibility annually vs. ‘I received Medicaid during the public health emergency, and I never understood, or it was never clearly conveyed to me, that normally this would not be continuous over multiple years,’” she said.

Harris is the Chair of the of the Alabama Medicaid Unwinding Task Force which has been working with state Medicaid officials to try to prevent such problems when the protections end in April.

For some Alabamians, language barriers may be an issue for understanding the changes, said Harris. For others who have changed addresses, they may not realize they need to update the state on their new address to keep their health coverage through Medicaid.

Alabama is likely to see its number of uninsured residents rise by 16 percent, the report by the Robert Wood Johnson Foundation and the Urban Institute found. By June of 2024, Alabama would have a total of 432,000 uninsured residents.

“The people most likely to churn in and out of Medicaid eligibility include young adults, workers with part-time jobs, and people with incomes close to eligibility cutoffs,” the report found.

People who receive letters saying they are no longer eligible for Medicaid coverage can appeal the decision. For those who lose coverage, their options would be buying insurance through the federal healthcare marketplace or getting it through work if they can. Children will be eligible for ALL Kids insurance, and their parents should get a letter with the option to have their coverage roll over, according to Harris.

In Alabama, a family of two earning more than $3,300 a year does not qualify for Medicaid. A member of the family must also be a primary caregiver to children to qualify.

Some states have expanded Medicaid to fix this coverage gap, but Alabama has not.

Many people who work minimum wage jobs and do not get health insurance through work, they earn too much to qualify for Medicaid, but too little to afford healthcare elsewhere, she said.

“There are going to be some people who don’t have affordable options even on the (federal) marketplace,” said Harris.