15 Million Americans Could Lose Medicaid Coverage Soon

Written by Jack Phillips on March 20, 2023. Posted in Current News

About 15 million people could lose their Medicaid coverage in the next year as states start to determine whether some individuals are eligible after a provision under the federal COVID-19 public health emergency is slated to expire in May

According to a Kaiser Family Foundation survey and analysis, some 18 percent of Medicaid recipients, or about 15 million people, will lose their health insurance coverage when states start removing people from their Medicaid rolls starting April 1.

“Millions of beneficiaries are expected to be disenrolled over the next year, including some who are no longer eligible for Medicaid and others who still qualify but lose coverage due to administrative paperwork problems,” said the Kaiser Family Foundation, which worked with Georgetown University to survey state officials regarding how they would disenroll people getting Medicaid.

“Among the just over one-third of states able to report, they estimate that about 18 percent of Medicaid enrollees will be disenrolled when the continuous enrollment provision ends. However, the estimates range widely across reporting states from about 7 percent to 33 percent of total enrollees,” Kasier said Thursday. “This estimated average disenrollment rate is slightly higher than the 13 percent reported by states in 2022, although it is consistent with other estimates indicating about 15–18 million people may lose Medicaid coverage over the coming year.”

It said that as states “unwind” the enrollment provision, many will likely not be eligible for Medicaid due to a variety of reasons, including exceeding income levels needed to enroll, said Kaiser. “Others could face administrative barriers and lose coverage despite remaining eligible.”

Kaiser stipulated that some states will attempt to allow certain individuals to retain coverage. More than two-thirds of the states surveyed are adopting an approach that would prioritize renewals “that considers multiple factors,” it said.

“At the same time, some states have not adopted these strategies. Several states lack fully automated systems, processing some or most renewals manually (12 states) and others have ex parte renewal rates below 25 percent (11 states), which will increase the administrative burden on staff and enrollees. Even among states that adopt policies to promote continuity of coverage, implementation of policies and systems capacity will be key in how enrollees fare during the unwinding,” it said.

As Kaiser released its analysis on Thursday, Rhode Island Gov. Dan McKee announced his administration is rolling out a plan “for the state to restart Medicaid renewals beginning on April 1.” Other governors have made similar announcements in recent days, while some, like Illinois, have warned that some Americans are facing a deadline to re-enroll easily.

The analysis notes that it is difficult to know exactly how many people will lose their coverage because different states have different plans and thresholds.

The process appears to be slow as 43 states indicated they would be “taking 12-14 months to complete renewals following the end of the continuous enrollment provision,” said Kaiser.

Under the federal emergency, states were mandated to require states to allow continuous enrollment in Medicaid, which is a program that provides health insurance for people with limited income or resources. During the COVID-19 pandemic, enrollment surged due to the program, according to Kaiser.

On Jan. 30, the Biden administration said it would end the COVID-19 health emergency on May 11, after more than three years.

The White House had said that previous emergency extensions were needed because it would trigger an “abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty” for health systems and Americans.

It came after House and Senate Republicans had increasingly called on the federal government to terminate the declaration. Some GOP-led states, too, wanted the emergency ended and claimed it was an undue financial strain.

Also in its report, Kaiser noted that processing Medicaid eligibility renewals and disenrollments comes when most state programs are facing staffing challenges.

More than half of states have vacancy rates of more than about 50 percent for call center staff and 10 percent for eligibility workers.

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