More Than 1 Million in US Lose Medicaid Health Care Coverage in Post-Pandemic Purge
Most got dropped for not filling out paperwork.
Though the eligibility review is required by the federal government, President Joe Biden's administration isn't pleased at how efficiently some states are accomplishing the task.
"Pushing through things and rushing it will lead to eligible people — kids and families — losing coverage for some period of time," Daniel Tsai, a top federal Medicaid official recently told reporters.
Already, about 1.5 million people have been removed from Medicaid in more than two dozen states that started the process in April or May, according to publicly available reports and data obtained by The Associated Press.
Florida has dropped several hundred thousand people, by far the most among states.
The drop rate also has been particularly high in other states. For people whose cases were decided in May, around half or more got dropped in Arkansas, Idaho, Kansas, Nevada, New Hampshire, Oklahoma, South Dakota, Utah and West Virginia.
By its own count, Arkansas has dropped more than 140,000 people from Medicaid.
The eligibility redeterminations have created headaches for Jennifer Mojica, 28, who was told in April that she no longer qualified for Medicaid because Arkansas had incorrectly determined her income was above the limit.
She got that resolved, but was then told her 5-year-old son was being dropped from Medicaid because she had requested his cancellation — something that never happened, she said. Her son's coverage has been restored, but now Mojica says she's been told her husband no longer qualifies. The uncertainty has been frustrating, she said.
"It was like fixing one thing and then another problem came up, and they fixed it and then something else came up," Mojica said.
'Swiftly disenroll'
Arkansas officials said they have tried to renew coverage automatically for as many people as possible and placed a special emphasis on reaching families with children.
But a 2021 state law requires the post-pandemic eligibility redeterminations to be completed in six months, and the state will continue "to swiftly disenroll individuals who are no longer eligible," the Department of Human Services said in statement.
Arkansas Governor Sarah Huckabee Sanders has dismissed criticism of the state's process.
"Those who do not qualify for Medicaid are taking resources from those who need them," Sanders said on Twitter last month. "But the pandemic is over — and we are leading the way back to normalcy."
More than 93 million people nationwide were enrolled in Medicaid as of the most recent available data in February — up nearly one-third from the pre-pandemic total in January 2020. The rolls swelled because federal law prohibited states from removing people from Medicaid during the health emergency in exchange for providing states with increased funding.
Now that eligibility reviews have resumed, states have begun plowing through a backlog of cases to determine whether people's income or life circumstances have changed.
States have a year to complete the process. But tracking down responses from everyone has proved difficult because some people have moved, changed contact information, or disregarded mailings about the renewal process.
Outreach via text, email, phone
Before dropping people from Medicaid, the Florida Department of Children and Families said it makes between five and 13 contact attempts, including texts, emails and phone calls. Yet the department said 152,600 people have been non-responsive.
Their coverage could be restored retroactively if people submit information showing their eligibility up to 90 days after their deadline.
Unlike some states, Idaho continued to evaluate people's Medicaid eligibility during the pandemic even though it didn't remove anyone. When the enrollment freeze ended in April, Idaho started processing those cases — dropping nearly 67,000 of the 92,000 people whose cases have been decided so far.
Advocates fear that many households losing coverage may include children who are actually still eligible, because Medicaid covers children at higher income levels than their parents or guardians. A report last year by the U.S. Department of Health and Human Services forecast that children would be disproportionately impacted, with more than half of those disenrolled still actually eligible.
That's difficult to confirm, however, because the federal Centers for Medicare & Medicaid Services doesn't require states to report a demographic breakdown of those dropped. In fact, CMS has yet to release any state-by-state data. The AP obtained data directly from states and from other groups that have been collecting it.
Some states haven't been able to complete all the eligibility determinations that are due each month. Pennsylvania reported more than 100,000 incomplete cases in both April and May. Tens of thousands of cases also remained incomplete in April or May in Arizona, Arkansas, Indiana, Iowa, New Mexico and Ohio.
"If states are already behind in processing renewals, that's going to snowball over time," said Tricia Brooks, a research professor at the Georgetown University Center for Children and Families. "Once they get piles of stuff that haven't been processed, I don't see how they catch up easily."