Researchers identified 13.4% of young adults with and 35.6% without complex medical conditions ended up disenrolled from Medicaid at 19 years old, according to a study published Feb. 16 in JAMA Pediatrics.
Researchers from the University of Chicago, the University of Illinois Chicago and the University of Minnesota in Minneapolis carried out the research. They defined disenrollment as at least two months without any days of comprehensive benefits.
In many states, Medicaid eligibility rules change at age 19, switching an enrollee’s status from child to adult. From ages 19 to 21, the overall probability of disenrollment was 37.9% for people with complex conditions and 74.2% for people without them, the study determined.
“It was known within health policy that there was increased disenrollment around age 19,” lead author Betsy Cliff, PhD, assistant professor of public health sciences at the University of Chicago, said in a university news release. “But we’re the first we know of to estimate the precise risk across this transition from childhood to adulthood for a national Medicaid population.”
The study found significant rate variation among states, as well. For adults without complex conditions, disenrollment rates by state ranged from 7.3% to 83.9%.
“Two equally sick people living in different places can have a very different probability of losing health insurance,” Dr. Cliff said.
Higher disenrollment risks include being male, eligibility through income-based rather than disability-based pathways, residence in states without expanded Medicaid and residence in states with high managed care penetration. Among those with complex conditions, mental health and cardiac conditions posed the highest disenrollment risk.
