Hundreds of Thousands Have Lost Medicaid Coverage Since Pandemic Protections Expired

Hundreds of thousands of low-income Americans have lost Medicaid coverage in recent weeks as part of widespread easing of pandemic-era policies that barred states from excluding their citizens from programs.

Early data shows that many Medicaid beneficiaries lost their coverage for procedural reasons, such as failure to return documents confirming eligibility or being unable to find their whereabouts. . The high number of cancellations for procedural reasons suggests that many people may be losing coverage even though they are still eligible. Many of those killed were children.

From the early days of the pandemic until this spring, states were barred from excluding people from Medicaid under the coronavirus relief provisions passed by Congress in 2020. Guaranteed continued coverage helped people escape routine eligibility checks during the public health crisis, and Medicaid enrollment surged to record levels.

But the policy expired at the end of March, and a massive bureaucratic operation was launched across the country to see who remained eligible for coverage. In recent weeks, states have begun releasing data on who has lost coverage and why, providing the first glimpse of the severe toll the so-called unwinding has taken on some of the poorest and most vulnerable Americans. .

so far at least 19 states Started removing people from rolls. The exact number of people who lost their insurance is not yet known.

In Arkansas, more than 1.1 million people, more than a third of the state’s population, were on Medicaid at the end of March. In April, the first month states could start removing people from programs, 73,000 lost their insurancewhich includes about 27,000 children under the age of 17.

Among those laid off was Melissa Buford, a diabetic with hypertension, who spends about a year at a clinic in eastern Arkansas helping her family find affordable health insurance. Earning $35,000. Her two adult sons also lost their insurance.

Like more than 5,000 others in the state, 51-year-old Buford lost his Medicaid eligibility because his income increased. She was very upset when she received her notice that she was ineligible and she threw it in the trash.

However, the majority of those who lost coverage in Arkansas were excluded for procedural reasons.

Daniel Tsai, a senior official at the Centers for Medicare and Medicaid Services who has helped oversee the Biden administration’s mitigation process, said more help was needed to help those who have lost coverage in this way. . He said federal officials are in regular contact with state officials across the country to review early data on reimbursement to make sure those who lose coverage have a fair chance to prove their eligibility. said.

Arkansas Gov. Sarah Huckabee Sanders (Republican) has positioned unwinding as a necessary process to save money and allow Medicaid to function within its intended scope.

“We are only removing ineligible participants from the program to keep resources for those in need and to comply with the law,” Sanders wrote. opinion essay In this month’s Wall Street Journal. “Some Democrats and activist journalists oppose Arkansas’ actions because they want to keep people dependent on the government,” he added.

Funded jointly by the federal government and states, Medicaid is a pervasive component of the US safety net. Earlier this year, 93 million Americans, more than one in four, had Medicaid or children’s health insurance programs, up from 71 million before the pandemic.

What has happened so far in Arkansas means that the unwinding process is likely to cause widespread disruption to families across the country in the coming months, with Americans looking to find new insurance or replace lost Medicaid coverage. It is evidence that we are forced to look for ways to get it back. procedural reasons.federal government About 15 million people are expected to lose their insuranceincluding about 7 million people who are still eligible but expected to be dropped.

One of the most pressing questions is how this process will affect children. For example, in Florida, a boy is in remission with leukemia and needs a biopsy. recently lost coverage.

Researchers at the Center for Children and Families at Georgetown University estimated that before demolition: more than half the children It was covered by Medicaid or CHIP in the US. According to the center’s executive director, Joan Arker, many children who have lost coverage will be excluded for procedural reasons, even though they are still eligible.

“They have nowhere else to turn to for coverage,” she says. “Medicaid is the single largest insurer for children.

Loretta Alexander, director of health policy for Arkansas Children and Family Advocacy, said many of the children in Arkansas who lost Medicaid were “the poorest of the poor.” She added that losing coverage would be especially detrimental to young children, who need regular developmental screenings from an early age.

Most states take about a year to roll back, and each state has its own approach to removing people from Medicaid. But in Arkansas, a bill passed in 2021 required state officials to complete the process in just six months. State Department of Human Services spokesman Gavin Resnick said state officials checked children’s eligibility for Medicaid early in the process because children make up a significant percentage of Medicaid recipients.

In his opinion essay, Mr. Sanders pointed to a campaign the state is rolling out to warn residents to relax. Renew Arkansas.

“We hired additional staff and volunteers to help,” she wrote. “We have texted, emailed and called tens of thousands of Arcanthans who are likely currently ineligible for Medicaid. , people with diseases such as cancer, people on dialysis, and pregnant women.”

Local health workers like Ms. Buford are trying to help those who are still eligible get their insurance back. She said she worked with 50 to 75 Medicaid beneficiaries who lost coverage in April, helping them fill out forms and answering questions about how to verify eligibility.

Other states have also removed large numbers of Medicaid recipients for procedural reasons.In Indiana, nearly 90 percent about 53,000 People who lost Medicaid in the first month of state relaxation were laid off for those reasons. in Florida, about 250,000 Most people who lost Medicaid coverage were due to procedural reasons.

In addition to taking different approaches to keeping people out of Medicaid, states publish data on progress in different ways, making it difficult to compare strategies in the early stages of mitigation. It is “We’re comparing apples to oranges and tangerines,” Alker said.

Some people who lose Medicaid coverage are expected to obtain health insurance through their employer. Others will likely use the Affordable Care Act marketplace to purchase private insurance, many of which will be eligible for premium-free plans.

Debra Miller, 54, of Bullhead City, Arizona, lost her Medicaid coverage in April after her income of about $25,000 a year as a chef at Burger King made her ineligible. Miller, a single mother with diabetes and hypothyroidism, worked with insurance counselors at North Country Health Care, a network of federally funded clinics, to get insurance for about $70 a month. I signed up for a free marketplace plan.

“It’s hard because it’s a new bill that’s never been done before,” she said. She added that she was worried about the cost of the eye exams she needed as a diabetic because her new plan didn’t include vision insurance.

Buford said Marketplace premiums would be too high for some people in Arkansas.

“You have a car, a mortgage, kids and food,” she said. “We really don’t have enough money left to pay such high health insurance premiums.”

Buford found her calling, helping people find health insurance in underserved areas. Said it happened. Buford attended a community college near her hometown to care for her ailing father, who died in her 40s. “I love my job because I can help people,” she said.

Buford said he’s lost Medicaid coverage and hopes to find an affordable market plan in the near future. The family plan offered by the clinic where she works is too expensive, she said.

“I appreciate what I have because other people don’t have what I have,” Buford said. “I wish I could have kept my Medicaid.”