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MEDICARE NEWS & COMPLIANCE

Nearly 8.7 million people have lost their Medicaid coverage.

Posted October 12, 2023

72% of persons who disenrolled had their coverage terminated for formalities (procedural disenrollments) across all states with data available. The other 28% were terminated because they were ineligible for Medicaid.

Procedural disenrollments are when people are dropped from the program because they did not finish the renewal procedure. These disenrollments can happen when the state has outdated contact information, the enrollee does not comprehend the renewal packets, or they do not finish them within a certain amount of time. High procedural disenrollment rates are alarming because many of the people who are dropped for these administrative issues might still be qualified for Medicaid benefits. While they resolve issues with the renewal process that result in an increase in procedural disenrollments, some states have temporarily halted procedural terminations for some subscribers.

In the 19 states that reported age breakdowns, 40% of Medicaid disenrollments involved minors. Out of the 4,255,000 total disenrollments in the 19 states as of October 11, 2023, at least 1,701,000 children had been removed. Texas has a disproportionate effect on the proportion of kids disenrolled because it has one of the largest Medicaid programs and because there aren't many states reporting. In Massachusetts, there were 14% fewer children enrolled than in Texas, where the percentage was 68%.

As of October 11, 2023, 56% of those whose coverage had been renewed had done so "ex parte", while 44% had done so using a renewal form. Before submitting a renewal form or asking for more evidence from an enrollee, states are obligated by federal regulations to first try to complete administrative (or "ex parte") renewals by confirming ongoing eligibility through readily accessible data sources, such as state salary databases. For example, renewal costs differ between states. Since the beginning of the unwinding period, 29% of all renewals that were due, including disenrollments and pending renewals, "were finished through ex parte procedures.

On March 31, 2023, the Medicaid continuous enrollment clause that had prevented Medicaid disenrollments since March 2020 came to an end. More than 94 million people were enrolled in Medicaid/CHIP in March 2023, the month before the unwinding period started, an increase of over 22 million from February 2020, primarily as a result of the continuous enrollment option. State Medicaid enrollee eligibility will be reevaluated when the continuous enrollment provision is phased out over the next 12 months, and those who are no longer eligible or who may still be eligible but are unable to finish the renewal procedure will be disenrolled. During this transitional time, millions of Americans are anticipated to lose their Medicaid coverage.

States started removing people off Medicaid at different times, with some starting in April, others in May or June, and some even in July or later.

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