Millions of Americans who gained Medicaid health insurance during the COVID-19 pandemic could lose that coverage this year or next when generous federal subsidies expire.
That’s according to a new Kaiser Family Foundation analysis that estimates that five million to 14 million Americans could lose Medicaid when states begin to unwind coverage after the Biden administration declares the coronavirus public health emergency is over.
The federal government provided billions in federal aid to states on the condition that they would not remove people from Medicaid until the health emergency ends.
The temporary measure to ensure that Americans didn’t lose coverage during the pandemic has been extended for more than two years.
The Kaiser foundation projects that sign-ups for full and partial Medicaid coverage will have swollen by 25% to 110 million by the end of September.
It’s been a lucrative deal for states, which have collected more than $100 billion in Medicaid funding and other financial relief over the past three budget years while spending a projected $47 billion to cover the pandemic Medicaid enrollees.
But the enhanced federal funding will cease during the quarter in which the public health emergency ends. The federal government will still pay a portion of the Medicaid tab for enrollees — but that federal match won’t be as generous. So some states might prioritize quick eligibility checks to ensure only those who still fully qualify continue in the program.
It’s a date that state Medicaid administrators and health policy experts are closely watching.
The health emergency currently is set to end July 15.
But every time a deadline has approached, the U.S. Department of Health and Human Services has extended it by another 90 days. HHS officials have said the administration will notify states 60 days before ending the emergency — which means the notification would need to in the coming week if the Biden administration intends to end the emergency in July.
When the emergency ends, state Medicaid agencies will have 12 months to check the eligibility of every person and notify those who no longer qualify.
People normally churn on and off Medicaid rolls when they gain or lose a job or family circumstances change. Many states are now checking mailing addresses and phone contacts of members to ensure they can quickly reach them when eligibility checks resume.
Enrollment experts encourage recipients to be prepared for and respond to mailings from state agencies to ensure their coverage is not improperly dropped.
Others must brace for the possibility they no longer will qualify and will lose coverage. In such cases, enrollment experts can inform people about other coverage options, such as the Affordable Care Act marketplace.
“That churn might happen again,” said Robin Rudowitz, director of the Kaiser Family Foundation’s program on Medicaid and the uninsured. “We know a lot of people may face barriers or red tape in terms of being able to maintain coverage even if they’re eligible.”
The Kaiser report said the groups most likely to lose coverage include adults who gained Medicaid eligibility under the Affordable Care Act, parents who aren’t disabled and some children.
The number of uninsured Americans dropped to 8.8% at the end of 2021 as millions gained Medicaid coverage, and the American Rescue Plan Act offered more generous Affordable Care Act marketplace subsidies that lowered premiums for many.
That could change when states resume eligibility checks and start disenrolling people.
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