Millions of people have been disqualified from Medicaid after the protections guaranteed by the Covid-19 pandemic expired about seven months ago. Many of these individuals, however, lost coverage for bureaucratic reasons and not necessarily because they do not qualify for the program.
The so-called “unwinding” process, in which states are re-determining Medicaid eligibility for the first time in three years, is highlighting the administrative and technical barriers that typically prevent many eligible individuals from enrolling or remaining enrolled in the program.
States regularly assess whether individuals enrolled in Medicaid still qualify based on income or other eligibility factors. But these checks were suspended during the pandemic, and enrollments in Medicaid and its sister program, the Child Health Plus, increased by nearly 30% during the pandemic, reaching over 92 million people by the end of 2022.
In addition to the challenge of re-enrolling tens of millions of people whose coverage was secure three years ago, outdated eligibility systems and technology in states, along with a labor shortage, are increasing the challenge of redefining who is eligible.
Consequence: More than 10 million people nationwide have lost Medicaid coverage since April, including about 7 in 10 who lost insurance for procedural reasons, according to KFF.
Some enrollees never received renewal notices because states do not have their current address. For many who did receive the notice, it was unclear what documents they needed to submit to remain covered.
The renewal process can vary significantly from state to state, as each state has the flexibility to manage its programs, which are run in conjunction with the federal government.
It is unclear how many people who lost Medicaid coverage found another type of insurance through an employer or elsewhere. Some, but not many, signed up for coverage through the subsidized insurance markets of the Affordable Care Act.
The rising uninsured rate is beginning to impact the healthcare system. The percentage of uncompensated hospital services as a share of operating revenue increased from 6.4% in March to 8.7% in July, according to data compiled by Syntellis Performance Solutions and published by the American Hospital Association.
The proportion of emergency visits among people with Medicaid coverage decreased by 2.8 percentage points during the period described above, while visits from those who are uninsured increased by 2.4 percentage points, according to Epic Research.
The large number of people losing Medicaid coverage due to bureaucratic hurdles may spur long-term improvements in Medicaid eligibility and enrollment systems, experts predict.
Source: Axios