One Year, 19M Disenrollments: A Look At Medicaid Redeterminations So Far

Threats of fines, procedural errors and more: Here are the major headlines from the past year of states unwinding Medicaid.

Published April 2, 2024

It’s been one year since states were allowed to begin disenrolling Medicaid members from the safety-net coverage. More than 19.2 million low-income people have lost health insurance because of that process, called redeterminations, to date.

It’s been a bumpy year for unwinding for a number of reasons, including variations in administration processes between states and a lack of resources at Medicaid agencies that have culminated in high levels of improper disenrollments.

Over 70% of those disenrolled to date have had their coverage terminated because of procedural reasons like missing paperwork or administrative lags, instead of actual ineligibility, according to health policy research firm KFF.

Those enrollees may still be eligible for Medicaid coverage, sparking concern among patient advocates, policy researchers and the Biden administration, which has repeatedly warned states to get their acts together. For example, just three months after beginning terminations, the federal government ordered 12 states to pause redeterminations to address issues causing procedural disenrollments.

Children have also been improperly removed from Medicaid, prompting regulators last year to threaten states with fines if they didn’t reinstate coverage.

And major insurers offering Medicaid coverage like Centene and Molina have been impacted, with upheaval in their member rolls throwing financial forecasts into doubt.

Here are the major headlines of Medicaid redeterminations so far.