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Millions Lose Coverage as Medicaid Renewals Move Forward

About 1.5 million people have lost Medicaid coverage during an unprecedented post-pandemic redetermination process, primarily due to neglect to fill out required eligibility paperwork.

For the first time in three years, states are requiring people on Medicaid to renew their coverage due to the end of continuous eligibility, which was put in place by the Families First Coronavirus Response Act of 2020. Continuous eligibility required states to keep people on Medicaid during the COVID-19 public health emergency even if they became ineligible due to income or family changes.

But, because the health emergency ended on May 11, states are now required to redetermine if individuals are still eligible for coverage.

In a press conference on April 5, Daniel Tsai, Deputy Administrator and Director of the Centers for Medicaid & Medicare Services (CMS), told reporters, "This is the most significant coverage event in the country since the implementation of the Affordable Care Act."

And as states sift through their Medicaid rosters to redetermine eligibility, many Americans are already experiencing the impacts of this Medicaid unwinding process.

According to the Associated Press (AP), in April and May, two dozen states began the process of redetermining eligibility resulting in around 1.5 million people losing coverage. However, most have lost coverage because they didn't fill out and send in the required paperwork.

The CMS refers to this as "administrative churn."

Administrative churn occurs when states send renewal information to individuals about their redetermination requirements. When people receive this information, they must complete the required paperwork and submit it to the state by a specific date.

However, because it has been three years since the states have sent renewals, many individuals have moved or not updated their contact information, so they might not receive the documents. In addition, some people might disregard the paperwork even if they have received the information.

If a person does not respond or fails to complete the paperwork in time, they could lose Medicaid coverage even if they are eligible.

The CMS previously predicted over seven million people could lose coverage due to administrative churn.

So far, the AP reports that several hundred thousand individuals in Florida and more than 140,000 in Arkansas have lost Medicaid coverage. In addition, around half of people with Medicaid lost coverage in Idaho, Kansas, Nevada, New Hampshire, Oklahoma, South Dakota, Utah, and West Virginia.

However, some states have tried preventing administrative churn by increasing contact attempts. For example, the Florida Department of Children and Families claims it makes between five and 13 contact attempts, including texts, emails, and phone calls. However, 152,600 people have been non-responsive, the AP reports.

Though many people who have lost Medicaid coverage likely qualify for Marketplace coverage and premium tax credits to reduce monthly premiums, some will fall into the coverage gap — where they don't qualify for Medicaid or subsidized coverage on the Marketplace. And this is most likely to happen in states that do not have Medicaid expansion options.


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