As the unwinding of the Medicaid continuous enrollment provision continues, the U.S. has hit a milestone in the number of people disenrolled from Medicaid. More than 10 million Medicaid enrollees have been removed from coverage as of November 1, according to data from KFF.
The continuous enrollment provision barred states from disenrolling Medicaid beneficiaries during the Covid-19 public health emergency. In return, states received enhanced federal funding. But the provision ended in March, and states are resuming the Medicaid redetermination process, in which states have to determine if individuals are still eligible for coverage.
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KFF’s data comes from several sources, including the Centers for Medicare and Medicaid Services and state websites.
Of those with a completed renewal, 35% were disenrolled while 65% had their coverage renewed. KFF noted that because of “varying lags for when states report data, the data reported here undercount the actual number of disenrollments to date.”
Disenrollment rates vary widely by state, ranging from 65% of total completed redeterminations in Texas to 10% of total completed redeterminations in Illinois, according to KFF. However, these differences can be partially explained by “who states are targeting with early renewals.” In addition, some states have different renewal policies.
“Some states (such as Texas and South Carolina) are initially targeting people early in the unwinding period that they think are no longer eligible or who did not respond to renewal requests during the pandemic, but other states are conducting renewals based on an individual’s renewal date,” KFF said. “Additionally, some states have adopted several policies that promote continued coverage among those who remain eligible and have automated eligibility systems that can more easily and accurately process renewals while other states have adopted fewer of these policies and have more manually-driven systems.”
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Of those disenrolled from Medicaid coverage, 71% were removed from coverage for procedural reasons, according to KFF. Procedural disenrollments are when people are terminated from coverage because they didn’t complete the renewal process. This can happen when states don’t have updated contact information or because the beneficiary didn’t complete the renewal packets in time.
“High procedural disenrollment rates are concerning because many people who are disenrolled for these paperwork reasons may still be eligible for Medicaid coverage,” KFF said.
Only 20 states report age breakouts on Medicaid disenrollments. But in those 20 states, children accounted for 39% of Medicaid disenrollments. This represents nearly 1.9 million children who were disenrolled out of the more than 4.8 million total disenrollments in the 20 states.
Of those who had their Medicaid coverage renewed, 57% had their coverage renewed on an “ex parte” basis. This is when states verify a beneficiary’s eligibility using available data sources like state wage databases before they send a renewal form to the beneficiary.
Those who aren’t eligible for Medicaid may be able to gain coverage through the Marketplace, employers or Medicare. However, “the big question now is if people will find and navigate to other coverage or if they will become uninsured,” noted Jennifer Tolbert, director of the State Health Reform and Data Program at KFF, in a statement.
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