More Than 20M Disenrolled Amid Medicaid Redeterminations

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Dive Brief:

• Over the past year, more than 20 million Medicaid beneficiaries have been disenrolled from the safety-net insurance program as states resumed checking eligibility for coverage after a pandemic-era pause.
• Overall, 31% of people with a completed redetermination were disenrolled from Medicaid as of April 11, according to a tracker by health policy research firm KFF. Sixty-nine percent, or more than 43 million people, had their coverage renewed. 
• Many people who were culled from Medicaid haven’t found other coverage. Nearly a quarter of adults who were disenrolled since early last year report currently being uninsured, according to a KFF survey. 

Dive Insight:

During the COVID-19 pandemic, enrollment in Medicaid soared due to the Families First Coronavirus Act, which provided increased federal funds for states as long as they agreed to not remove beneficiaries from coverage during the public health emergency.

But that period of continuous enrollment ended about a year ago, and states have since been determining who is still eligible for the safety-net program.

The process has been confusing for some Medicaid enrollees, research suggests. About two-thirds weren’t sure if states could remove beneficiaries from the program if they didn’t meet eligibility requirements, according to a survey published shortly after unwinding began last year. 

There’s also been significant variation across states when it comes to redeterminations, and many people have been disenrolled for procedural reasons, according to KFF. In states with available data, 69% had their coverage terminated because they didn’t complete the renewal process, which could mean they’re still eligible.

As the unwinding continued last year, regulators stepped in to stem the tide of procedural disenrollments, which could happen because beneficiaries didn’t understand the process or because states listed outdated contact information.

Regulators also paused disenrollments in some states, and issued an order last fall that particularly aimed to protect children from being inappropriately disenrolled due to a systems issue with automatic renewals. 

Children accounted for 37% of disenrollments in the 14 states that reported age breakdowns, according to the latest KFF update. Texas has had a disproportionate impact on the number of children disenrolled, due to its large size. The share of children cut from Medicaid was 65% in the state, compared with 20% in Oregon.