The Biden administration has recently expressed grave concerns over many individuals losing their Medicaid coverage. This is mainly due to procedural issues such as non-compliance with paperwork requirements or failure to return necessary forms. Recent data from the federal Centers for Medicare and Medicaid Services reveals that approximately 715,000 people had their health coverage terminated in 18 states that initiated a post-pandemic review of their Medicaid rolls in April.
The Procedural Pitfall
About 79% of these terminations were due to “procedural reasons.” This means that the individuals either failed to return the renewal form they received in the mail or the state could not reach them. A smaller percentage, nearly 21%, lost their Medicaid coverage because they were deemed ineligible.
The Impact of the Pandemic on Medicaid Enrollment
The pandemic saw a significant increase in Medicaid enrollment, from 71 million in February 2020 to 93 million in February 2023. However, with the ban on disenrollment lifted in April 2023, states have resumed their standard annual redeterminations, leading to a decline in Medicaid coverage.
The Predicted Fallout
Healthcare advocacy groups like the Kaiser Family Foundation (KFF) estimate that as many as 3.8 million Medicaid enrollees could have been disenrolled as of July 28. As states continue to unwind the continuous enrollment provision, KFF predicts that 15-18 million individuals could lose their Medicaid coverage over the next year.
The Call to Action
Health and Human Services Secretary Xavier Becerra has been vocal about his concerns regarding the high rates of procedural terminations due to red tape and other paperwork issues. He has urged governors to adopt measures to keep people on the Medicaid rolls. One such action includes using information from other federal programs, like food stamps, to automatically confirm people’s eligibility for Medicaid, thereby eliminating the need for mailing and returning documents.
The State of Affairs Across States
Some states have adopted policies that promote continued coverage among eligible enrollees, including automating their eligibility systems to process renewals more efficiently and accurately. Nine states meet eight or more out of nine metrics for promoting continuity of coverage. However, six states meet four or fewer of the measures, indicating a need for improvement.
The Role of Insurance Companies
Insurance companies running Medicaid programs for states are also trying to reduce terminations and enroll people in new plans. For instance, Elevance Health and Molina Healthcare lost many Medicaid customers due to eligibility redeterminations. However, they expect many to reenroll soon. Molina is also assisting those no longer eligible for Medicaid to switch to individual insurance plans available through state-based marketplaces.
The surge in people losing Medicaid due to red tape is a pressing issue requiring immediate attention and action from state officials and insurance companies.