26 Feb MEDICAID ENROLLMENT TO RETURN TO PRE-PANDEMIC SIZE
Medicaid enrollment is being significantly affected due to the expiration of the continuous enrollment condition authorized by the FFCRA. Since April, millions of people 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 shows that approximately 9.5 million individuals have been removed from Medicaid since enrollment peaked last April. This trend suggests that Medicaid should return to its pre-pandemic program size of 71 million individuals 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 every month.
Many individuals 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 originally predicted that about 15 million individuals would lose coverage throughout the unwinding phase. However, their estimate was conservative compared to the present data. According to KFF, disenrollments are expected to surpass 17 million, with procedural issues accounting for 70 percent of these instances.
However, around two-thirds of the 48 million Medicaid recipients who have undergone eligibility reviews so far have successfully had their coverage renewed, while about one-third have lost it.
There are, however, significant variations in how enrollment is being affected among states. For example, Oregon has only disenrolled 12 percent of its beneficiaries. 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 varied eligibility criteria, with some implementing policies that make it much easier for members 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 regardless of income fluctuations.
Industry experts have expressed ongoing concern about the sharper decrease in Medicaid enrollment among children contrasted to usual enrollment patterns. This is particularly troubling since children normally qualify for Medicaid at higher household income limits than their parents or other adults. According to current data from Georgetown University, over 3.9 million children have experienced a loss of Medicaid coverage in the course of the unwinding.
Utah was the only state to survey those who were disenrolled and discovered that about 30 percent were uninsured. Many others secured employer health insurance coverage or enrolled in subsidized plans through the ACA.
The continuous enrollment requirement’s expiration has greatly impacted Medicaid enrollment. It marks the single most significant health coverage transition event since the first open enrollment period of the ACA. Because of the varying eligibility requirements across the country, some states are being impacted more than others. As they navigate the second half of the unwinding period, states must make every effort to communicate enrollment status changes to their program recipients and ensure that their vulnerable populations do not lose coverage.