December 8, 2023

Supporters held signs that read “Save Medicaid” at a news conference for Senate Democrats at the Capitol, joining disability advocates against the Republican Graham-Cassidy health care bill.

Bill Clark | Chongqing Rolling Name Company | Getty Images

Nearly 3 million people have been taken off Medicaid since their Covid-19 pandemic protections expired in April, and three-quarters of them have lost their coverage, although they may still be eligible for public health benefits, according to health researchers. health insurance plan Cave.

Medicaid is a public health insurance program for low-income individuals and families. It is heavily funded by the federal government but primarily administered by state governments.

The widespread cancellation of insurance is a worrying trend because because of the complexities of the U.S. health insurance system, people who lose one type of coverage often have difficulty finding replacement coverage, putting them at risk of ending up uninsured.

About 75% of the 2.7 million people who lost Medicaid coverage in 32 states and Washington, D.C., were excluded from the program because they didn’t complete the renewal process, according to the latest figures released Monday. .

That means their coverage may have been terminated even though they are still eligible for Medicaid.

Texas and Florida have seen the most Medicaid cancellations in recent months. Of the 500,000 people in Texas who lost their coverage, 81% of them ended their coverage because they did not complete the renewal process. In Florida, 300,000 people lost their insurance, and 65% of them didn’t complete the paperwork.

The number of people losing Medicaid coverage this month will only grow as 11 more states start renewal programs for the first time in two years, including big states like California and New York.

The U.S. Department of Health and Human Services estimates that as many as 15 million people could lose their coverage when the dust settles, though many of them are expected to switch to alternative coverage.

However, while nearly 7 million people are still eligible for the program, they could lose Medicaid coverage, according to the U.S. Department of Health and Human Services (HHS).

red tape

Congress barred states from canceling Medicaid during the Covid-19 public health emergency in exchange for increased funding. As a result, Medicaid enrollment ballooned to a record high of more than 86 million people by March 2023, a 26% increase from February 2020, according to the Centers for Medicare & Medicaid Services.

Those Medicaid coverage protections expired in April after lawmakers added a provision to federal spending legislation in December allowing states to begin kicking people out of the program who are no longer eligible. Medicaid eligibility is largely based on income.

But many people lost their coverage simply because of bureaucratic red tape. This usually happens when the country’s contact information is out of date and the person cannot be reached. In other cases, a person may not understand how the renewal process works, or fail to submit documents by the deadline.

Completing the paperwork to renew Medicaid coverage can be especially difficult for people with limited English proficiency, said Jennifer Tolbert, a KFF expert on Medicaid and the uninsured.

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HHS estimated last year that one-third of those at risk of losing Medicaid were Hispanic and 15 percent were Black. Current data for most states is not broken down by population group.

Large numbers of children also lost Medicaid. In Arkansas, Arizona, Indiana, Oklahoma, Virginia and Washington, at least 250,000 children have dropped out of Medicaid, according to KFF. The national total is likely higher because many states do not provide information on how many children have lost coverage.

alternative coverage

Health experts worry that people, even those who are truly no longer eligible for Medicaid, may not switch to another insurer or coverage under the Affordable Care Act (commonly known as Obamacare) because of income changes and other reasons. People have to apply for Obamacare every year, and some may not know how the process works.

HHS opened special enrollment period Helping those who have been eliminated from Medicaid find alternative coverage through Obamacare.

In a letter to U.S. governors in June, HHS Secretary Xavier Becerra expressed his deep concern that many people needlessly lose out on Medicaid.

Becerra called on governors to do everything they can to ensure people don’t lose their coverage for avoidable reasons. The number of people losing Medicaid has more than doubled since Becerra sent that letter.

The agency has the power to prevent states from ending people’s Medicaid coverage if the Department of Health and Human Services determines that local authorities are not doing enough to confirm an individual’s eligibility. CNBC has reached out to HHS for comment on the latest data.

Tolbert said limited data from a handful of states suggested that the number of people switching to other forms of insurance appeared to be low, but she said that could change as more information became available.

If people struggle to return to Medicaid or transition smoothly to other coverages such as Obamacare, the rate of uninsured people in the U.S. could increase, Tolbert said.