Millions of Americans got Medicaid coverage during the pandemic. Starting next year, millions are likely to lose it.
The mammoth expense project approved by Congress would allow states to take some people off Medicaid starting in April. Millions would be left uninsured, according to estimates by the administration and various health care nonprofits.
The Kaiser Family Foundation estimates that between 15 and 18 million people will lose Medicaid coverage, or about 1 in 5 people currently in the program. a december to study by the centrist Urban Institute also estimated that 18 million people will lose Medicaid coverage next year and in 2024, leaving 3.8 million people without health insurance.
“The reality is that millions of people are going to lose Medicaid coverage,” said Jennifer Tolbert, deputy program director for Medicaid and the uninsured at the foundation.
public health emergency
From the coronavirus first hit in 2020, enrollment in Medicaid, the health insurance program for low-income people, has increased by 20 million, to nearly 84 million people, according to KFF. That’s by design: When the administration first declared the public health emergency (PHE), it also prohibited states from taking people off Medicaid.
In a typical year, many people enroll in Medicaid and many others leave as their income or circumstances change. States routinely check Medicaid members to make sure they remain eligible for the program and screen out anyone who isn’t. The public health emergency halted that process.
“There are many reasons why people switch from Medicaid, but what PHE has done is that, in the last few years, no one has left Medicaid,” Tolbert said.
The spending bill would allow states to start removing people as of April 1. The federal government will also reduce additional funding given to states for additional enrollments over the next year under the proposal.
“Reversing the continued coverage provision of pandemic Medicaid is likely to be extremely challenging, and states have important work to do to protect people from losing health coverage,” said Allison Orris, a senior fellow at the Center on Budget and Policy Priorities. , of liberal tendency, in a recent blog to post.
Before states remove members from Medicaid, they must verify patient eligibility and notify people if they lose coverage.
“What the state is required to do is use available electronic data sources to assess whether the person is still eligible for Medicaid. They will check things like residency, whether they still live in the state, what their current income is, and their family situation. , and — based on that, do they still meet the eligibility requirements?” Tolbert said.
However, he added, it’s not unusual for people who are eligible for Medicaid nonetheless to be dropped from the program due to language barriers or administrative oversight. “Maybe at their annual renewal they missed a notice to provide the documentation, or they didn’t know how to provide the documentation,” he said.
Advocates have also raised concerns about how states will notify enrollees if they are expelled from the program and what their options are. The effort will be particularly challenging for some of the country’s poorest people, who may not have a stable residential address or access to internet or phone services to verify their status.
When will people lose coverage?
The spending blanket bill allows states to take people off Medicaid starting April 1, but it will likely take longer for many. The Centers for Medicare and Medicaid has recommended that states take a full year to re-evaluate everyone in the program, although states are not required to follow that guidance.
“Getting these people off Medicaid is not going to happen on day one,” said Chris Meekins, an analyst at Raymond James who follows healthcare. “I hope that red states have already taken steps to identify who they think is most likely to be ineligible, to target those people first,” he said.
Many people who lose Medicaid will be able to find other health insurance, such as through an employer, the Affordable Care Act marketplace, or, in the case of children, the Children’s Health Insurance Program. But around 5 million will remain uninsured, a potentially devastating situation.
“Those people really don’t have anywhere else to go for coverage,” Tolbert said. “Because they are still eligible for Medicaid…they can’t go to the marketplace and get coverage.”
Even if those people do eventually re-enroll in the program, experts fear that going months without health insurance could be detrimental to anyone with ongoing health care problems.
“You may go to your doctor’s office and find out you don’t have coverage, and you can’t get services that day because you need to reapply” for Medicaid, Tolbert said.
Health care advocates urge people with Medicaid to make sure their contact information is up-to-date on their accounts and to check their mail frequently for eligibility status as the date of enrollment approaches. April 1st.
The spending bill also frees up additional funds to pay for more stable health insurance coverage for children in low-income households by requiring states to keep those children on Medicaid for at least a year after they are signed up.
Associated Press contributed reporting.
