Over 5 Million People Are Projected to Lose Medicaid Coverage Under the Plan Proposed by Congress

• Author: Noah King
• Posted: 2024-07-12

Millions of Medicaid recipients are projected to lose coverage starting in April when a clause meant to prevent states from terminating individuals during the COVID-19 health crisis expires.

This may cause medical treatment to be disrupted for many low-income people and others, with several newly uninsured people compelled to seek medical care at emergency rooms or forego pricey prescription drugs.

Furthermore, hospitals, particularly those in rural areas, may incur further debt as they absorb the expenses of treating an influx of uninsured patients.

When millions of individuals lose Medicaid coverage, community health clinics will suffer as well. This will have an impact on the centers' finances and capacity to assist medically underprivileged areas.
 

What Is Continuous Medicaid Enrollment?

States were expected to keep most people permanently registered on Medicaid under the FFCRA, which was approved in March 2020. States that approved this and other conditions earned more federal funds in exchange.

Previously, states re-evaluated members' eligibility, including their income, on a regular basis. People's coverage would be reinstated if they still fulfilled the eligibility standards at the moment of the redetermination.

According to the Kaiser Family Foundation, Medicaid enrollment has increased by 19.8 million individuals since the outbreak began. This was partly owing to the provision for continual enrolment.

Without ongoing enrollment, a person may lose Medicaid coverage due to a variety of factors, including changes in income owing to a salary rise or taking on temporary second employment.

Administrative difficulties can sometimes result in a person losing Medicaid coverage, a situation known as "administrative churn." This might happen, for example, if a person or the state commits an error during the redetermination procedure or if a member misses vital communications because they relocated.

The COVID-19 national health emergency will conclude in May, while the Medicaid continual enrollment provision is set to expire on March 31. As a result, states can begin processing redeterminations and disenrolling people who no longer are eligible on April 1. They will get 14 months to assess the eligibility of members.

Members will have a specified number of days to furnish necessary information after receiving informed from their state about the re-evaluation process. Members may lose Medicaid coverage if they do not reply within that time window.
 

How Many People Will Be Denied Coverage?

According to KFF, between 5 million and 14 million persons will lose Medicaid coverage in the year after the termination of continuous enrollment. This is less than the HHS's projection of 15 million people losing Medicaid coverage. According to the department, around 6.8 million Americans would be unenrolled even if they still qualify.

Returning to normal has been a major focus following COVID, but normal Medicaid wasn't working for many.

For instance, it's possible that those who are houseless or without a permanent address won't be informed when it's time to provide their income information. Additionally, it's possible that individuals who joined Medicaid when continuous enrolling was in effect are unaware of how the redetermination procedure operates.

It's possible that certain states are more motivated than others to retain people enrolled in the Medicaid program. These will take a more active role in informing members about the discontinuation of continuous enrolment.

Despite states' and community organizations' attempts to educate individuals about the ending of continuous enrollment, a considerable number of people will find out the hard way by turning up at the doctor's office or pharmacy and realizing they don't have a cover.
 

How Will This Affect People?

According to pre-pandemic data, a high number of people would likely remain uninsured for some time after losing Medicaid coverage. According to KFF research based on 2016-2019 data, about two-thirds of those disenrolled from Medicaid experienced a gap in coverage the following year. According to the study, around four out of ten disenrolled people returned to Medicaid after a year (known as "churn").

Many people who are no longer eligible for Medicaid are expected to acquire other coverage, like employer-sponsored insurance. Furthermore, certain consumers may be eligible for a premium tax credit to help reduce the monthly payment of a health plan acquired via the Health Insurance Market.

One cause for worry is the impact of the loss of coverage on patients who receive care from specialists, like those who suffer from chronic diseases such as diabetes, heart problems, or depression. People who lose their Medicaid coverage could also be unable to pay for vision or dental treatment, as well as prescription drugs.
 

Don't Get Caught Without Coverage

Here are a few tips for Medicaid members on how to navigate the end of continuous enrollment:
• Verify that your state has your right address
• When you receive a letter, act quickly

If your Medicaid policy is about to expire, search for replacement cover as soon as you can.