Strategies for addressing 'Medicaid churn': Viewpoint

Millions of people are expected to lose Medicaid coverage when the federal public health emergency ends. This challenge presents an opportunity for states to address the issues of "Medicaid churn," researchers at New York City-based New York University and Boston-based Harvard T.H. Chan School of Public Health write in a Nov. 3 JAMA Health Forum paper. 

Though many are expected to lose coverage when pandemic continuous enrollment requirements end, Medicaid churn is an  "enduring problem," the authors said. This occurs because many Medicaid-eligible households' incomes fluctuate from month to month. When household income is too high to qualify for Medicaid, they can lose insurance for months at a time. 

Allowing households to stay continually eligible for Medicaid for a full year, regardless of income fluctuations, could help resolve churn, the authors write. Several states already have this policy in place for children, and New York allows this for all Medicaid-eligible individuals. 

"The insistence by policymakers on classifying everyone into the right insurance slot is intended to keep the public costs of the healthcare system down, even at the human cost of coverage disruptions because of Medicaid churn," the authors wrote. 

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