Republican-Led States Like Florida and Arkansas See Highest Levels of Coverage Loss
In April, states began the process of unwinding their Medicaid programs, and a recent analysis from the Kaiser Family Foundation shows that more than half a million Americans have already lost their health care. News coverage over the last several weeks makes clear that Republican-led states like Florida and Arkansas are moving far too quickly to throw people off the rolls. Some states are failing to ensure that people know their rights or eligibility for financial assistance under the Affordable Care Act or other health care programs. Instead of doing everything in their power to keep people covered, Republican governors like Ron DeSantis are using this opportunity to slash their Medicaid rolls.
It’s no surprise that red states are moving to throw people off their coverage given the GOP’s longstanding hostility towards Medicaid and affordable health care. In Florida, nearly 250,000 people have lost their coverage in a state that continues to reject Medicaid expansion, making it harder for families to find affordable coverage options. This comes as Republicans in Congress recently attempted to impose even more paperwork requirements in Medicaid and boot 21 million people off of their health care.
Congress passed legislation at the beginning of the COVID-19 pandemic to protect access to Medicaid by ensuring no one could be disenrolled during the public health emergency, but this provision expired on April 1. Experts fear that as many as 15 million people nationwide could lose their health care due to procedural requirements and bureaucratic red tape, disproportionately impacting people of color, children, and people in rural communities.
KFF Health News: As Medicaid Purge Begins, ‘Staggering Numbers’ of Americans Lose Coverage. “The overwhelming majority of people who have lost coverage in most states were dropped because of technicalities, not because state officials determined they no longer meet Medicaid income limits. Four out of every five people dropped so far either never returned the paperwork or omitted required documents, according to a KFF Health News analysis of data from 11 states that provided details on recent cancellations. Now, lawmakers and advocates are expressing alarm over the volume of people losing coverage and, in some states, calling to pause the process.” [KFF Health News, 6/1/23]
Politico: 500,000 Dropped From Medicaid — So Far. “That’s the number of people in 11 states who have already been taken off the Medicaid rolls since redetermination started, according to a new analysis from KFF. The total number of people disenrolled varied significantly by state — as did the percentage of total completed renewals affected. Florida tops the charts for both measures, with nearly 250,000 removed from the rolls, equaling about half the number of completed renewals.” [Politico, 6/1/23]
Washington Post (Opinion): Government Incompetence Is Knocking Eligible Americans Off Medicaid. “Here’s where the numbers get especially infuriating. States are supposed to break out how many people lost coverage because they were reassessed for eligibility and actually determined to no longer qualify (because their income rose, for example, or they aged out of the children’s health insurance program) versus how many people lost coverage for pointless ‘procedural’ reasons (e.g., the state never received documentation needed to reassess eligibility). Based on the states that have publicly released breakdowns so far, the majority of people losing Medicaid are casualties of those paperwork-related reasons.” [Washington Post, 6/1/23]
New York Times: Hundreds of Thousands Have Lost Medicaid Coverage Since Pandemic Protections Expired. “Hundreds of thousands of low-income Americans have lost Medicaid coverage in recent weeks as part of a sprawling unwinding of a pandemic-era policy that prohibited states from removing people from the program. Early data shows that many people lost coverage for procedural reasons, such as when Medicaid recipients did not return paperwork to verify their eligibility or could not be located. The large number of terminations on procedural grounds suggests that many people may be losing their coverage even though they are still qualified for it. Many of those who have been dropped have been children.” [New York Times, 5/26/23]
The Hill: Millions Had Medicaid Coverage Tied To The Pandemic. Now They Stand To Lose It. “Many will lose coverage due to no longer being eligible, but others stand to become uninsured due to ‘administrative churn,’ a term federal agencies use to refer to clerical issues that prevent people from receiving services. These obstacles include changes of address, insufficient contact information or enrollees simply struggling with the renewal process. Joan Alker, director of the Center for Children and Families at the Georgetown McCourt School of Public Policy, said she has observed high rates of ‘procedural denials’ in some states, meaning people were denied coverage due to not completing the renewal process, not because they were ineligible.” [The Hill, 5/29/23]
Tampa Bay Times: Florida Not Doing Enough To Keep Children On Medicaid, Health Advocates Warn. “Health care advocates are sounding the alarm over how Florida is handling last month’s end of emergency Medicaid, which they warn could force thousands of eligible children to lose medical coverage because their parents don’t know they must reapply to the federal program. One reason they don’t know, according to advocates, is that Florida officials haven’t done enough to reach out to families and that some of its messaging is causing confusion.” [Tampa Bay Times, 6/2/23]
KUER 90.1: Bad Paperwork Is Driving Most Of The Turnover On Utah’s Medicaid Rolls. “In Utah, the biggest driver of lost coverage has been procedural reasons, like bad paperwork or missed contacts. Since the protections ended, almost 20,000 Utahns have lost coverage for that reason…On June 5, the department disclosed that a ‘mailing error’ resulted in Medicaid information for an estimated 5,800 Utahns being mistakenly put in incorrect envelopes and sent to the wrong addresses. The agency said new letters would be sent out over the next two weeks.” [KUER, 6/5/23]
Arkansas Times: Arkansas’s Rush To Prune Medicaid Roster “Not Normal,” Leaves Thousands In Limbo. “Phasing out pandemic-era policies is complicated, and the Biden Administration gave states a year to clean the Medicaid rolls. But thanks to state lawmakers, Arkansas is pruning Medicaid lists in six months instead, forcing tradeoffs between speed and due diligence. The result is that people who are eligible for Medicaid are losing it anyway.” [Arkansas Times, 5/23/23]
Associated Press: North Dakota Health Officials Urge Return Of Medicaid Renewal Forms As Thousands Lose Coverage. “State Health and Human Services says about 13,000 Medicaid recipients in North Dakota were due for renewal at the end of May, but thousands failed to return their forms, so many lost coverage even though they may still qualify, KFGO reported.” [Associated Press, 6/6/23]
Vox: Hundreds Of Thousands Of Americans Are Losing Medicaid Every Month. “Policy experts and advocates warned before the eligibility checks began that people who are still eligible for Medicaid could lose their insurance due to administrative problems, such as not receiving mail from the state or not returning documentation to confirm they are still eligible. Now the early evidence suggests that’s exactly what is happening. In Florida, for example, more than 80 percent of people who were dis-enrolled from Medicaid were kicked off for procedural reasons. About the same share of people who lost coverage in Arkansas and Indiana were deemed ineligible because they failed to report information to the state or because the state could not reach them. Only a small percentage of people — about one in seven in Arkansas — were removed because they were no longer eligible (i.e., their income had grown to the point it exceeded Medicaid eligibility limits).” [Vox, 5/19/23]
Politico: The Looming Medicaid Crisis. “Most people currently on Medicaid will still be eligible — if they get through the notification and recertification process. Others will be eligible for heavily-subsidized plans on the Affordable Care Act markets, or may get covered at work. In fact, almost everybody will be eligible for something — except those who fall in the ‘Medicaid gap,’ in the 10 states still resisting Obamacare’s Medicaid expansion. (Two other states have approved expansion although it hasn’t kicked in yet.) But health care is difficult to navigate. Understanding the Medicaid unwinding, figuring out what you are eligible for and then actually getting signed up are three different things, each with its own complexities.” [Politico, 5/22/23]