On April 1st, pandemic-era protections that kept individuals enrolled in Medicaid were rolled back. The Local Department of Social Services (DSS) resumed redeterminations, reducing or terminating Medicaid coverage for those who are no longer eligible. Experts anticipated that approximately 300,000 North Carolinians would lose access to affordable health care as a result.
To address the looming crisis, Advocacy Center staff engaged in extensive outreach and education efforts with beneficiaries and providers. The team offered webinars educating those impacted by the change, initiated a state-wide communication effort to increase awareness and connect beneficiaries with critical resources, and engaged the community and our partners through numerous outreach events. Efforts were focused on educating individuals and families about their rights and how to navigate the complicated process to ensure they maintain access to care. In addition, staff continued to provide legal assistance to beneficiaries facing service or eligibility denials.
As a result of a settlement agreement reached in October 2022 in Franklin v. Kinsley, formerly known as Hawkins v. Cohen, the Advocacy Center is in a unique position to ensure beneficiaries’ rights will be protected during the redetermination process. In the settlement agreement, the North Carolina Medicaid agency agreed to extensive and very detailed changes to its procedures, forms, and notices for redetermining Medicaid eligibility for those currently enrolled in Medicaid. Through enforcement of the settlement agreement, legal staff can ensure the 2.8 million North Carolinians with Medicaid will not lose coverage for which they are still eligible due to procedural terminations.