WASHINGTON —

If you get health care coverage through Medicaid, you might be at risk of losing that coverage over the next year.

Roughly 84 million people are covered by the government-sponsored program, which has grown by 20 million people since January 2020, just before the COVID-19 pandemic hit.

But as states begin checking everyone's eligibility for Medicaid for the first time in three years, as many as 14 million people could lose access to that health care coverage.

A look at why so many people may no longer qualify for the Medicaid program over the next year and what you need to know if you're one of those people who relies on the program.

What's happening to Medicaid?

At the beginning of the pandemic, the federal government prohibited states from kicking people off Medicaid, even if they were no longer eligible. Before the pandemic, people would regularly lose their Medicaid coverage if they started making too much money to qualify for the program, gained health care coverage through their employer or moved into a new state.

That all stopped once COVID-19 started spreading across the country.

Over the next year, states will be required to start checking the eligibility again of every person who is on Medicaid. People will have to fill out forms to verify their personal information, including address, income and household size.

When might I lose my coverage?

That will vary depending on which state you live in; some states are moving faster than others to check eligibility. Arizona, Arkansas, Florida, Idaho, Iowa, New Hampshire, Ohio, Oklahoma and West Virginia are among the states that will begin removing ineligible Medicaid recipients as early as April.

Other states will start taking that step in May, June or July.

Not everyone will be removed from the program all at once. States plan to verify all recipients’ eligibility over periods of nine months to one year.

How will I be notified if I'm losing my coverage?

If you rely on Medicaid for care, it’s important to update your contact information, including home address, phone number and email with the state from which you receive benefits.

States will mail a renewal form to your home. The federal government also requires states to contact you in another way -– by phone, text message or email –- to remind you to fill out the form.

Even if mailed notices reach the right address, they can be set aside and forgotten, said Kate McEvoy, executive director of the nonprofit National Association of Medicaid Directors.

“A text might just grab someone’s attention in a way that would be more accessible,” she said, noting that a quick message also may be less intimidating than a mailed notice.

Most states have already used texting for things such as reminding patients to get a COVID-19 vaccine or about upcoming doctor’s visits. But sending mass texts on Medicaid eligibility will be new, McEvoy said.

You will have at least 30 days to fill out the form. If you do not fill out the form, states will be able to remove you from Medicaid.

What are my options if I'm kicked off Medicaid?

Many people who will no longer qualify for Medicaid coverage can turn to the Affordable Care Act’s marketplace for coverage, where they’ll find health care coverage options that may cost less than $10 a month.

But the coverage available on the marketplace will still be vastly different from what’s offered through Medicaid. Out-of-pocket expenses and co-pays are often higher. Also, people will need to check if the insurance plans offered through the marketplace will still cover their doctors.

A special enrollment period for people who are unenrolled from Medicaid will start March 31 and last through July 31, 2024. People who lose Medicaid coverage can submit an application at any time during that period after losing coverage and will have up to 60 days to select their plans, according to guidance the Centers for Medicare and Medicaid Services sent to states last month.

My children are enrolled in Medicaid. What will happen to their coverage?

More than half of U.S. children receive health care coverage through Medicaid or the Children’s Health Insurance Program.

Even if you receive a notice that you’re no longer eligible for Medicaid, it’s likely that your child still qualifies for the program or for health care coverage through CHIP, which covers children whose families make too much money qualify for Medicaid but don’t earn enough to afford private health insurance.

Between 80% and 90% percent of children will still be eligible for those programs, according to estimates from the Georgetown University Health Policy Institute’s Center for Children and Families.

“When a parent receives a message that they aren’t eligible anymore, they often assume their child is no longer eligible either,” said Joan Alker, the center’s executive director. “It’s more common to find that the parent is no longer eligible for Medicaid, but the child still is.”

___

Associated Press writer Tom Murphy in Indianapolis contributed to this report.

The pandemic has made staffing at nursing homes even more challenging. But for the first time, it's easier for people in the U.S. to find out what staff turnover is like at nursing homes in their area.

Medicare is now posting those details on its Care Compare website. Visitors can select a particular nursing home and then click to view staffing information.

Experts like Dr. David Gifford with the American Health Care Association say staffing turnovers at nursing homes are often high because of how payments are structured.

"We've historically been known to have a high turnover, as other sectors are too, and a lot of it relates back to that most of the nursing homes paid by Medicaid," Gifford said. "We just weren't able to offer the competitive wages that hospitals and other health care providers are."

The Centers for Medicare & Medicaid Services has researched the links between staff turnover and quality of care. Initial results suggest that as staff turnover decreases, the overall quality rating for a facility increases.

Starting this summer, the agency will use staff turnover information to calculate facility quality ratings.

Giffords says many workers at nursing homes do want to stay in their jobs. But he points to factors like low wages or child care problems as reasons for leaving.

"The staff there really do end up caring for the residents, almost as if their family members, and so it's very hard when someone leaves," he said. "We need to recognize that, and I think this data just shows that not making nursing homes sort of a priority has led to more turnover, and we need to solve that root problem with this information."

Medicare says posting the new turnover information for consumers won't create additional paperwork burdens for nursing homes. The data is already regularly reported to the government — it's just now becoming accessible to the public.

The Federal Communications Commission announced Friday it has approved funds to provide internet subsidies for low-income families through the establishment of the Emergency Broadband Benefit Program.

The FCC says the program will provide eligible households with discounts of up to $50 a month for broadband service, and up to $75 a month if the household is on Tribal lands. It also will provide a one-time discount of up to $100 on a computer or tablet for eligible households, the FCC added.

The FCC says that the program is open to Lifeline subscribers, including those that are on Medicaid or accept SNAP benefits; households with children receiving free or reduced-price lunch or school breakfast; Pell grant recipients; and those who have lost jobs and seen their income reduced in the last year.

The program is expected to cost $3.2 billion.

“This is a program that will help those at risk of digital disconnection. It will help those sitting in cars in parking lots just to catch a Wi-Fi signal to go online for work,” said acting FCC chairwoman Jessica Rosenworcel. “It will help those lingering outside the library with a laptop just to get a wireless signal for remote learning. It will help those who worry about choosing between paying a broadband bill and paying rent or buying groceries. In short, this program can make a meaningful difference in the lives of people across the country.”

The program is expected to begin within 60 days. The FCC has not launched a signup program yet, but when updated information will be available by clicking here.

Justin Boggs is a writer for the E.W. Scripps National Desk. Follow him on Twitter @jjboggs or on Facebook.

Studies have shown that the COVID-19 pandemic has caused more people around the globe to experience depression, anxiety and substance abuse. Now, a bipartisan policy center has created a task force to look into those specific issues and is proposing solutions that can help.

“The Bipartisan Policy Center is proposing that we advance the idea of integrating primary care and behavioral health services,” said Dr. Regina Benjamin, a former surgeon with the task force.

Benjamin is a doctor in a small town near Mobile, Alabama. She says in her own practice, she spends a lot of time looking for behavioral health specialists that can take patients in need of mental health care.

Part of the Bipartisan Policy Center’s new suggestions is to expand training to primary care providers so they can handle the treatment for mild to moderate mental health and substance abuse conditions. They also suggest bringing mental health nurses or psychiatrists into the same office as primary care physicians and have mental health providers available to provide care through telehealth.

“It would be so much more helpful if we had an integrated electronic health record that integrated with the psychiatrists or psychologists. Right now, those records don't talk to each other,” Benjamin said.

The Bipartisan Policy Center report also suggests moving to “value-based” care payment structures so doctors aren’t paid just for checking blood pressure but improving it.

The Center also wants to see Medicare coverage of telehealth permanently expanded.

“In the end, basically, this integrated system will improve access to services access to care. It improves the outcomes, it decreases the health disparities, it's cost-effective, it saves the system money and, at the end of the day, it helps us become a more healthy nation.”

The report mentions several states already moving toward physical and mental health care integration, demonstrating positive results and lowering costs through Medicaid.