Millions of Americans have obtained Medicaid coverage during the pandemic. Starting next year, millions of people risk losing it.
the mammothpassed by Congress would allow states to kick certain people out of Medicaid starting in April. Millions of people are no longer insured, according to estimates by the administration and several nonprofit health care organizations.
The Kaiser Family Foundation estimates that 15 to 18 million people will lose their Medicaid coverage, or about 1 in 5 people currently in the program. A December study by the centrist Urban Institute also estimated that 18 million people are expected to lose their Medicaid coverage next year and in 2024, leaving 3.8 million people without health insurance.
“The reality is millions of people are going to lose Medicaid coverage,” said Jennifer Tolbert, the foundation’s associate director of the program on Medicaid and the Uninsured.
Public health emergency
SinceFirst hit in 2020, enrollment in Medicaid – the health insurance program for low-income people – rose by 20 million, to nearly 84 million people, according to KFF. That’s by design: When the administration first declared a public health emergency (PHE), it also prohibited states from kicking people out of Medicaid.
In a normal year, many people enroll in Medicaid and many more leave as their income or circumstances change. States perform routine checks on Medicaid members to ensure they are still eligible for the program and reject anyone who is not. The public health emergency has halted this process.
“There are many reasons why people switch from Medicaid, but what PHE has done, for the past few years, no one has left Medicaid,” Tolbert said.
The spending bill would allow states to start deporting people from April 1. The federal government will also reduce additional funds to states for new enrollees over the next year under the proposal.
“Unwinding continued Medicaid coverage during a pandemic is likely to be extremely difficult, and states have important work to do to protect people from losing their health coverage,” said Allison Orris, senior fellow at the Center on Liberal-leaning Budget and Policy Priorities in a recent blog post.
Before states remove Medicaid members, they are required to verify patient eligibility and notify people if they are losing coverage.
“What the state is required to do is use available electronic data sources to assess if the person is still eligible for Medicaid. They will check things like residency, do they still live in the state , what their current income and marital status are, and .based on that, do they still meet the eligibility requirements,” Tolbert said.
However, she added, it is not uncommon for people who are eligible for Medicaid to still be excluded from the program due to language barriers or administrative oversight. “Perhaps during their annual renewal, they missed a notice to provide documents, or they didn’t know how to provide documents,” she said.
Advocates have also expressed concerns about how states will notify enrollees if they are kicked out of the program and what their options are. The effort will be particularly difficult for some of the country’s poorest people, who may not have a stable home address or access to the internet or phone services to verify their status.
When will people lose their coverage?
The omnibus spending bill allows states to remove people from Medicaid starting April 1, but many will likely take longer. The Centers for Medicare and Medicaid have recommended that states take a full year to reassess everyone in the program — though states aren’t required to follow those guidelines.
“Moving these people out of Medicaid won’t happen on day one,” said Chris Meekins, an analyst at Raymond James who tracks health care. “I expect the red states have already taken steps to identify who they believe are 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.
“These people really have nowhere to go to get coverage,” Tolbert said. “Because they remain eligible for Medicaid…they can’t go into the market and get coverage.”
Even if those people do eventually re-enroll in the program, experts worry that going without health insurance for months could be unsettling for anyone with lingering health issues.
“Maybe you go to your doctor’s office and find you don’t have coverage, and you can’t get services that day because you have to reapply” for Medicaid, Tolbert said. .
Health care advocates are urging people on Medicaid to make sure their contact information is up-to-date on their accounts and check the mail frequently to keep an eye on their eligibility status as the deadline approaches. dated April 1.
The spending bill also frees up additional funds to pay for more stable health insurance coverage for children from low-income households, by requiring states to keep those children on Medicaid for at least a year once they signed up.
The Associated Press contributed reporting.