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From stigma to difficult documentation, Granite Staters face barriers in accessing Medicaid

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Health Insurance

When Melissa Bernardin of Concord applied for Medicaid coverage for the first time during the COVID-19 pandemic, she said the application process was confusing and difficult.

She expected it would take her around 30 minutes.

“It took three hours,” Bernardin said.

Despite applying for an income-based program, she said she needed to provide unexpected documentation like the amount of savings in her retirement account and debt she owed on her cars.

A spokesperson for the New Hampshire Department of Health and Human Services says someone applying for an income-based program should not have to provide the department with asset information.

The complicated and confusing documentation process is one of the barriers Granite Staters applying for or renewing their Medicaid coverage face, according to a new report from Rights & Democracy, the Center for Popular Democracy and researchers at Columbia University.

The report features results from a survey of 76 New Hampshire Medicaid applicants and recipients, conducted between February and August of 2021. 44 percent said they had long wait times when they called an office for assistance.

The report recommends staffing call centers adequately to meet demand, as well as improving eligibility determination systems to make the process more organized.

The New Hampshire Medicaid department says it has received funding through the state’s Executive Council to hire more call center staff. Accessible phone support could become even more important for about 86,000 Granite Staters who risk losing their coverage when federal public health emergency protections end.

They risk losing their coverage because of missing documentation or overdue redetermination forms.

But long phone times and confusing documentation aren’t the only challenges in accessing Medicaid coverage.

31 percent of people surveyed said a sense of shame or stigma was a hurdle in the application or renewal process. For the people of color in the survey, the burden of stigma was significantly higher, with 67 percent reporting it was a challenge for them.

The assistance process is even more complicated for those who need language support, Eva Castillo, director of the New Hampshire Alliance of Immigrants and Refugees said at a Tuesday press conference discussing the report.

She also said the state could do more to make sure immigrants in New Hampshire have access to health insurance. One step, she said, would be eliminating the five year eligibility wait times for Medicaid for some lawful residents of the state, like children and pregnant people who are not yet citizens. Dozens of other states have already removed that requirement. House Bill 1578 could do the same in New Hampshire.

“This bill would help only the most vulnerable among that group of people, which are the pregnant people and the children,” Castillo said.

The bill does not cover undocumented immigrants or DACA recipients.

Other proposed legislation would expand adult dental benefits for Medicaid recipients, which right now, are limited to just emergency services and lengthen postpartum care for low-income pregnant people from 60 days after giving birth to a year.

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