Medicaid enrollment is being significantly affected because of the expiration of the continuous enrollment condition authorized by the FFCRA. Since April, millions of people have been disenrolled from the program. Simultaneously, millions of others have either re-enrolled or enrolled in the program for the very first time.
State data shows that roughly 9.5 million people 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 individuals are being disenrolled within a condensed timeframe during the unwinding process. In some states, the situation has proven to be more severe than expected.
The Biden administration at first projected that approximately 15 million individuals would lose coverage during 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, roughly two-thirds of the 48 million Medicaid beneficiaries who have undergone eligibility reviews thus 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 instance, Oregon only disenrolled 12 percent of its beneficiaries. KFF reports that 75 percent were successfully renewed, while the remaining cases are still pending. Oklahoma disenrolled 43 percent of its program recipients during the unwinding phase, renewing coverage for only 34 percent. About 24 percent of cases are still pending.
States have varied eligibility requirements, with some implementing policies that make it much easier for members to remain enrolled. For instance, in Oregon, children can remain 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 trends. This is especially troubling since children usually qualify for Medicaid at higher household income limits 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 during the unwinding.
Utah is the only state to survey those who were disenrolled and found that somewhere around 30 percent were uninsured. Many others obtained employer health coverage or enrolled in subsidized plans through the ACA.
The termination of the continuous enrollment requirement has caused 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 varying 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 relay enrollment status changes to their program recipients and ensure that their vulnerable populations do not lose coverage.
The termination of the continuous enrollment requirement has caused 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 varying 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 relay enrollment status changes to their program recipients and ensure that their vulnerable populations do not lose coverage.
