It's been more than seven months since the first states began the process of unwinding the continuous Medicaid enrollment period in place for three years during the pandemic, resulting in state agencies and beneficiaries reporting major operational challenges and exacerbated care access issues.
"The unwinding effort continues to be very challenging and a significant lift for all states," Kate McEvoy, executive director of the National Association of Medicaid Directors, told KFF Health News in Nov. 8.
"This is an unprecedented situation," Joan Alker, executive director of the Georgetown Center for Children and Families, told the New York Times Nov. 9. The process "has the potential to increase the uninsured rate for children by the largest amount that we've seen in decades."
"It's not just bad, but worse than people can imagine," Camille Richoux, health policy director for Arkansas Advocates for Children and Families, told KFF Health News Nov. 8. "This unwinding has not been about determining who is eligible by all possible means, but how we can kick people off by all possible means."
Five key redeterminations updates:
1. Since April 1, more than 10 million people have been disenrolled from Medicaid across all 50 states and Washington, D.C., with 71% of those individuals losing coverage for procedural reasons rather than being determined ineligible, according to KFF. How procedural disenrollment rates are calculated varies by state, but high rates suggest many people that have lost coverage may still be eligible for Medicaid.
2. As a percentage of all disenrollments to date, 15 states have procedural disenrollment rates at or higher than 80%. As a percentage of all renewals that are due, Utah has the highest procedural rate of 51%.
3. As of Nov. 8, more than 2 million children have been disenrolled from Medicaid. This data, however, is limited because only 21 states report age brackets within their redeterminations data.
4. More than 94 million people were enrolled in Medicaid/CHIP before redeterminations began, and states have reviewed eligibility for more than 28 million people to date. For those with renewed coverage, 57% had their eligibility proven administratively, while 43% of renewals occurred through manual verification.
5. The country's largest Medicaid managed care insurer, Centene, reported 75% growth year over year in Q3 for its individual marketplace business. While many disenrolled Medicaid beneficiaries are finding health coverage elsewhere, final uninsured rates post-redeterminations likely won't be known until 2025.