26 Feb MEDICAID ENROLLMENT PREDCITED TO RETURN TO 71 MILLION
Medicaid enrollment is being significantly affected due to the close of the continuous enrollment provision authorized by the Families First Coronavirus Response Act. Since April, millions of program beneficiaries have been disenrolled from the safety net program. At the same time, millions of others have either re-enrolled or enrolled in the program for the very first time.
State data suggests that approximately 9.5 million individuals have been removed from Medicaid since enrollment peaked last April. This trend suggests that Medicaid should go back to its pre-pandemic program size of 71 million members after the unwinding.
Churn in enrollment has long been characteristic of Medicaid. Before the pandemic, an estimated 1 million to 1.5 million people dropped off Medicaid rolls each month.
Many members are being disenrolled within a condensed timeframe during the unwinding process. In some states, the situation has proven to be more severe than anticipated.
The Biden administration at first predicted that about 15 million individuals would lose coverage during the unwinding phase. However, their estimate was conservative compared to present data. According to KFF, disenrollments are expected to surpass 17 million, with procedural issues accounting for 70 percent of these cases.
That being said, roughly two-thirds of the 48 million Medicaid beneficiaries who have undergone eligibility reviews so far have successfully had their coverage renewed, while one-third have lost it.
Additionally, there are significant variations in how enrollment is being affected among states. For instance, Oregon only disenrolled 12 percent of its program’s population. 75 percent were successfully renewed, while the remaining cases are still pending. Oklahoma disenrolled 43 percent of its Medicaid beneficiaries during the unwinding, renewing coverage for only 34 percent. About 24 percent of cases are still pending.
States have diverse eligibility criteria, with some implementing policies that make it much easier for participants to remain enrolled. For example, in Oregon, children can stay on Medicaid until the age of 6 without needing to reapply, while all other individuals receive up to two years of coverage despite income fluctuations.
Industry analysts have expressed ongoing concern about the sharper decrease in Medicaid enrollment among children contrasted to usual enrollment patterns. This is specifically troubling since children typically qualify for Medicaid at higher household income thresholds than their parents or other adults. According to the latest data from Georgetown University, over 3.9 million children have experienced a loss of Medicaid coverage in the course of the unwinding process.
Utah is the only state to survey those who were disenrolled and found that about 30 percent were uninsured. Many others secured employer health insurance coverage or enrolled in subsidized plans through the ACA.
The termination of the continuous enrollment requirement made a tremendous impact on Medicaid enrollment. It marks the most significant health coverage transition event since the first open enrollment period of the ACA. Because of various eligibility requirements across the country, some states are being affected more than others. As they navigate the second half of the unwinding phase, states must make every effort possible to communicate enrollment status changes to their beneficiaries and ensure that their vulnerable populations do not lose coverage.