Medicaid disenrollments higher than expected: Report

The number of people disenrolled from Medicaid through the redeterminations process has surpassed original estimates from the Urban Institute and Robert Wood Johnson Foundation. 

According to a May 2 report, as of November 2023, nearly 9 million people had been disenrolled from Medicaid. The figure came out to 60.5% of the foundation's original estimate of 14.8 million people losing coverage, with several months remaining in the redetermination process. 

States began the process of redetermining the eligibility of Medicaid recipients for the first time since 2020 in April 2023, after continuous eligibility requirements in place during the COVID-19 pandemic expired.  

The number of people disenrolled varies widely by state and age group. In Oklahoma, disenrollment had reached 189% of the Urban Institute's projected numbers by November. In other states, numbers were much lower. 

In Oregon, just 6% of the number the Urban Institute projected would lose coverage were disenrolled as of November. 

Children were disenrolled from coverage at a higher rate than adults overall, according to the report. As of November, net disenrollment had reached 84.2% of the Urban Institute's projections. In 12 states, child disenrollments exceeded the Urban Institute's projections by September. 

According to the Urban Institute, states that planned to complete the Medicaid unwinding process in less than 12 months had higher disenrollment rates. States that obtained few waivers from CMS to ease the unwinding process and states that prioritized renewal of those likely to be ineligible also had higher disenrollment rates. 

Some of those disenrolled may eventually reenroll in Medicaid, the researchers wrote, but even a few months uninsured can disrupt care and lead to negative health outcomes. 

"In particular, we know that children, because of their rapid development at young ages, are at higher risk relative to adults of negative health consequences when there are disruptions in care because of spells without coverage," the researchers wrote. 

Different agencies produced slightly different estimates of how many people would be disenrolled through redeterminations. CMS estimated 15 million people would lose Medicaid coverage through the process. Disnerollements surpassed 15 million in January. 

As of May 1, at least 21 million people have been disenrolled from Medicaid, according to KFF. Of those disenrolled, 7 in 10 lost coverage for procedural reasons, rather than being determined to be ineligible on the basis of income. 

Read the full report here. 

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