'Replacing one public health crisis with another': Have Medicaid redeterminations been a disaster?

Medicaid redeterminations have thrown state agencies and millions of vulnerable people into chaos nationwide, a situation being described as an "emerging disaster," according to a July 27 column in the Los Angeles Times by Michael Hiltzik, a Pulitzer prize-winning reporter and writer.

"In stark terms, the U.S. is replacing one public health crisis — the pandemic — with another," he wrote.

After a three-year period of continuous Medicaid/CHIP enrollment under the COVID-19 public health emergency, states could begin terminating coverage for ineligible residents in April, though most started in May, June or July. Early data from state Medicaid agencies has shown many people in some states are losing health coverage for the wrong reasons.

As of July 19, at least 3 million people have been disenrolled from Medicaid since redeterminations began, according to KFF. Of those disenrolled, 74 percent were due to procedural reasons, rather than being determined ineligible for the program. 

The rates of procedural terminations vary by state, with three states — New Mexico, Georgia and South Carolina — and Washington, D.C., reporting procedural termination rates above 90 percent. 

On July 19, CMS said it has required a half-dozen states to pause terminations and reinstate individuals whose Medicaid coverage was terminated without the full due process required. 

"It's fair to say that the eventual end of the pandemic emergency was always pre-ordained, if not its timing," Mr. Hiltzik said. "That doesn’t make the chaos afflicting the vulnerable Americans dependent on Medicaid any less disgraceful."

HHS has estimated that 15 million people total will lose Medicaid coverage during redeterminations. The Congressional Budget Office estimated May 24 that 9.3 million people will transition to other forms of health insurance through 2024, and 6.2 million will remain uninsured. Because of that, the CBO estimates the nation's record uninsured rate of 8.3 percent will increase to 10.4 percent by 2029.

"The nation is now poised to walk back the gains in health coverage that were achieved during a horrifically challenging public health emergency," Mr. Hiltzik wrote. "Can any rational person explain why?"


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