Over 15 million Americans face the risk of losing their Medicaid coverage as pandemic-related safeguards expire, prompting states to begin dis-enrollment. Despite efforts to prevent coverage loss, data from 14 states suggests that over 600,000 individuals have already lost Medicaid since April. Many may lose coverage due to both ineligibility and administrative issues, raising concerns about potential health impacts. The conclusion of the COVID Public Health Emergency has also ended various healthcare provisions, causing higher costs and accessibility challenges for patients.
“An astounding number of over 15 million Americans are at risk of losing their Medicaid coverage as pandemic-related protections ensuring Medicaid coverage have been lifted. Many states have initiated the process of disenrolling specific individuals, which could result in approximately 15 million people losing their coverage within the next year.
A comprehensive examination of the conclusion of the COVID Public Health Emergency
The likelihood of millions of Americans losing their Medicaid coverage
In 2020, states receiving enhanced Medicaid funding were prohibited from removing individuals from the program during the COVID-19 public health emergency. Throughout the pandemic, Medicaid enrollment experienced a substantial increase, with over 91 million individuals enrolled in either Medicaid or CHIP as of October.
However, the requirement for continuous coverage recently expired on March 31. If someone becomes ineligible for Medicaid, they will have until July 31, 2024, to enroll in coverage through the federal Affordable Care Act marketplace.
Despite assurances from health officials that they are working to prevent people from losing coverage, an analysis conducted by KFF Health News (KHN) of data from 14 states suggests that over 600,000 Americans have already lost Medicaid coverage since April 1. Additionally, tens of thousands of children are losing their coverage, even though some may still qualify for Medicaid or CHIP.
In summary, around 15 million people could lose their coverage within the coming year as states assess individuals’ eligibility.
While some may lose coverage due to ineligibility, others may face coverage loss due to “administrative churn,” which encompasses bureaucratic issues that hinder people from accessing services. These issues could include address changes, a lack of contact information, or difficulties with the renewal process.
Furthermore, many people are unaware of potential changes to their Medicaid coverage. According to a recent KFF poll, two-thirds of Medicaid enrollees indicated uncertainty about whether states could remove individuals from Medicaid if they were no longer eligible or if they had not completed the renewal process. Almost half of them reported having never gone through the renewal process because it was on hold during the pandemic.
Louise Norris, a policy analyst for HealthInsurance.org, remarked, “The KFF data was, I think, alarming, but not particularly surprising given this has been the concern that a lot of policymakers have had throughout this.”
According to a KHN analysis of data from 11 states, 80% of the individuals who have lost coverage either failed to return renewal paperwork or lacked certain required documents.
For example, in Indiana, 53,000 people lost Medicaid coverage in the first month of the state’s eligibility review, with 89% losing coverage due to procedural reasons.
What are the implications of this situation?
Indiana State Representative Ed Clere (R) expressed his concern over the substantial number of individuals losing their coverage, labeling it as “staggering.” He fears that this could significantly impact patients’ health, particularly if they postpone seeking care due to lack of coverage.
He is worried that these cancellations could initiate an “avoidable revolving door” where individuals dropped from Medicaid may refrain from filling prescriptions and cancel doctor appointments due to costs. He stated, “Months down the line, after untreated chronic illnesses spiral out of control, they’ll end up in the emergency room where social workers will need to again help them join the program.”
While Indiana’s Medicaid officials have indicated their intention to refine the renewal process over time, advocacy coalitions in other states are assisting families in appealing their coverage decisions. However, Clere is advocating for more immediate changes to prevent people from unnecessarily losing their coverage.
He stated, “I’m just concerned that we’re going to be ‘learning’ as a result of people losing coverage. So I don’t want to learn at their expense.” (Choi, The Hill, 5/29; Recht, KFF Health News, 6/1)
A COMPREHENSIVE LOOK INTO THE CONCLUSION OF THE COVID PHE
As the COVID-19 public health emergency (PHE) came to an end in May, several healthcare provisions and waivers introduced during the pandemic, including those related to vaccines, telehealth, insurance coverage, and more, have also concluded. This has resulted in increased costs and greater challenges for patients in accessing care.”
