Medicaid redeterminations are going worse than expected, experts say

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. With redeterminations underway, health policy experts say too many people in some states are losing health coverage for the wrong reasons.

"Too many people are falling through the cracks in the system," Alison Yager, executive director of the Florida Health Justice Project, told Vox on May 19. "This should be of grave concern to all those charged with protecting the health of our residents."

In Florida, nearly 250,000 individuals have been disenrolled from the state's Medicaid program over the last month, but 82 percent of those disenrolled saw their coverage terminated because their information was not updated with the state. About 44,300 individuals made too much to be eligible and were referred to other coverage options.

"This is extremely troubling and is similar to the scary numbers we saw in Arkansas last week, where approximately 80 percent of the terminations were for procedural reasons," Joan Alker, executive director and co-founder of the Georgetown University Center for Children and Families, wrote in a blog post May 16. "When governors see such large numbers of terminations of coverage for procedural reasons, they should pause the process and see what is going wrong."

In Indiana, which began terminating coverage in May, nearly 53,000 people have been disenrolled from Medicaid, with 88 percent of the terminations due to procedural reasons, according to Ms. Alker.

She noted that it is difficult to compare states' redetermination processes because each Medicaid program is prioritizing different groups and reporting data differently. 

Other states, however, such as Pennsylvania, are reporting fewer terminations due to procedural reasons, according to Ms. Alker. In Pennsylvania, more than 77,000 people have been reviewed, about 8,000 people have lost coverage, and 45 percent lost coverage due to procedural reasons.

HHS has estimated that 15 million people total will lose Medicaid coverage during redeterminations.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months