Why Millions of Americans are about to lose Medicaid Coverage 

Up to 14 million Americans could lose Medicaid coverage this summer as eligibility requirements revert back to pre-pandemic rules. 

Enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) increased dramatically during the pandemic, when the federal government implemented a “continuous enrollment provision” that instructed state agencies to continue providing coverage to recipients even if they had lost eligibility. According to the Kaiser Family Foundation, enrollment in the two programs has increased by 20.2 million since February of 2020 to reach a total of more than 84 million people. 

With the continuous enrollment provision ending April 1st, states will soon begin to sift through recipients to determine who has lost eligibility due to relocation, income changes, employment, etc. The process, referred to as “the unwinding,” is expected to take between 9 and 12 months. 

Idaho has come under fire for being among the first states to remove ineligible recipients from Medicaid rolls, going so far as to drop 10,000 people during the first two years of the pandemic. In most cases, mailings were returned with no forwarding address or an out-of-state forwarding address and officials could not confirm if the individuals still lived in Idaho.

The move earned criticism from the US Centers for Medicare and Medicaid Service and by July of 2022 the state had returned coverage to some 6,400 recipients despite not being able to get into contact with them. As reported by NPR this month, an estimated 150,000 of Idaho’s 450,000 Medicaid enrollees no longer meet eligibility requirements and can expect to lose coverage soon.

Nationwide, “the unwinding” is expected to result in between 5 and 14 million people losing Medicaid coverage. “The lower estimate accounts for factors, such as new people enrolling in the program…while the higher estimate reflects total disenrollment and does not account for churn or new enrollees,” reports Kaiser.

Those who are kicked from the program will have a chance to apply for coverage between the dates of March 31st and July 31st of next year. Individuals who are no longer eligible for Medicaid are encouraged to visit the Affordable Care Act’s marketplace to find coverage. Regardless of eligibility, all Medicaid recipients will be required to fill out a renewal form to confirm their personal information. Forms will be sent via mail and states are required by law to send reminders through phone, text, and/or email. Individuals who fail to fill out the renewal form within 30 days could lose coverage. 

The US Department of Health and Human Services predicts up to 7 million people will lose coverage simply because they do not have the proper address on file or they fail to complete the form on time. Unfortunately, some Americans may not realize they are no longer covered by Medicaid until they seek care.

“In a perfect situation, a member responds to give you their current address, a phone number, an email address, etc.,” says Jack Rollins, director of federal policy for the National Association of Medicaid Directors. “But that is not the case for a lot of situations.”

It’s important to note that kids covered by CHIP do not automatically lose coverage if their parents are no longer eligible for Medicaid, explains Joan Alker, executive director for the Georgetown University Health Policy Institute’s Center for Children and Families. According to a study conducted by the Center, between 80% and 90% of children in the US are eligible to receive healthcare coverage through CHIP. 

Author’s Note: It will be interesting to see if President Joe Biden takes action on this. Medicaid could become a major issue for Democrats if voters associate the Biden Administration with loss of healthcare coverage.

Sources:

Why millions on Medicaid may lose coverage this year 

Medicaid to Drop 14 Million from Program Under New Rules 

Idaho dropped thousands from Medicaid early in the pandemic. Which state’s next?