New Medicaid recipients happy with care, unsure how to re-enroll

Newly enrolled Medicaid beneficiaries are generally happy with the coverage they have received despite some access-to-care issues, according to focus group findings prepared for the Medicaid and CHIP Payment and Access Commission.

To date, 27 states and the District of Columbia have expanded Medicaid to individuals earning between 100% and 138% of the federal poverty level under guidelines in the Patient Protection and Affordable Care Act.

As of this month, 8 million people have signed up for Medicaid or the Children's Health Insurance Program since exchanges opened last October, according to the CMS, up 14% from this same period last year.

Before expansion, most of those interviewed had been putting off care or incurring what for them was substantial medical debt to receive needed care. Since joining Medicaid, they feel less stressed about bills and about their health, researchers from PerryUndem Research/Communication said in their findings for the commission.

Those with chronic health conditions or mental health issues such as depression say their conditions are improving since joining Medicaid. Some have had health conditions diagnosed since enrolling which they previously were unaware of and are happy they can now afford treatment.

It hasn't been all smooth sailing, however, focus group members said. Some feel there is stigma with the program and worry they will have difficulty finding a provider or accessing certain treatments. Concern also exists that care will be of lower quality, according to the report.

Further, some have found that their pharmacy or Medicaid will not fill particular prescriptions.

“These participants are frustrated by the back-and-forth with the pharmacy. In some cases, the cause of the problem is a communication problem between the Medicaid managed-care plan and the pharmacy, and in others it is between the provider and the pharmacy,” the report says.

Others have access-to-service issues. One participant was told he could not have a procedure done to relieve pressure from a cyst because it was not infected or did not pose a health threat, for example. Others had similar experiences.

Despite some program shortcomings, all interviewed said they want to stay enrolled in Medicaid, assuming their income remains within eligible levels.

“They do not want to be uninsured again, and they appreciate that they can access providers and health care for little or no cost,” the report said.

Most focus group participants have not heard about the renewal process, however, and are unaware of how to stay enrolled in Medicaid.

Researchers conducted six focus groups with new beneficiaries in Colorado, Illinois and Oregon to develop their report (PDF), released Wednesday.

The report was previewed during a MacPAC meeting Friday.

Follow Virgil Dickson on Twitter: @MHvdickson