In the wake of the COVID-19 pandemic, over a million individuals have been removed from Medicaid due to several states rapidly ending their healthcare coverage. The leading cause for their removal was a failure to complete the necessary paperwork.
This mandatory eligibility review, enforced by the federal government, has been executed swiftly by some states, unsettling President Joe Biden’s administration.
“Speeding through processes will inevitably result in eligible individuals, including children and families, experiencing a lapse in coverage,” a high-ranking federal Medicaid official commented Daniel Tsai.
As per available public reports and data, around 1.5 million individuals have been eliminated from Medicaid across over two dozen states, which commenced in April or May. Florida stands out for dropping several hundred thousand individuals, the highest among all states. Other states, including Arkansas, Idaho, Kansas, Nevada, New Hampshire, Oklahoma, South Dakota, Utah, and West Virginia, also have high removal rates.
Jennifer Mojica, 28, experienced the disarray caused by the eligibility reevaluations. After having her and her son’s Medicaid revoked and then reinstated due to administrative errors, Mojica now faces potentially removing her husband’s coverage.
Arkansas, which itself removed over 140,000 people from Medicaid, claimed to prioritize automatic coverage renewals, particularly for families with children. Yet a 2021 state law mandates completion of post-pandemic eligibility redeterminations within six months, prompting the state to rapidly remove individuals who no longer qualify, per the Department of Human Services.
The number of people enrolled in Medicaid nationwide rose by almost a third from the pre-pandemic total in January 2020 to over 93 million in February. Federal law prohibited states from removing individuals from Medicaid during the health crisis while providing increased funding.
With eligibility reviews restarted, states are now working through a backlog of cases to confirm whether people’s financial or living situations have changed. Yet tracking responses has proven challenging due to changed addresses, updated contact information, or ignored renewal notices.
In Florida, five and 13 attempts to reach individuals are made before they are removed from Medicaid. Yet, of these, 152,600 people have been non-responsive. Their coverage may be retroactively reinstated if they can prove their eligibility within 90 days of their deadline.
Idaho, unlike some other states, continued to assess Medicaid eligibility throughout the pandemic, albeit without removing anyone. Since the enrollment freeze ended in April, Idaho has released nearly 67,000 out of 92,000 people whose cases have been reviewed.
The eligibility review process has been met with frustration from Medicaid recipients across numerous states. Julie Talamo from Florida endured a protracted battle to ensure her special-needs son remained on Medicaid, expressing that “this system was designed to fail people”.
Ongoing uncertainty surrounds the outcomes of numerous cases. Gary Rush, 67, from Pittsburgh, faces the loss of his Medicaid coverage due to his retirement savings, leaving him unsure of how to cover his $700 monthly diabetes medication costs.
Samantha Richards, 35, from Indiana, shares this anxiety despite being on Medicaid her entire life. She fears the system’s unpredictability, worrying that a missed deadline or overlooked paperwork could leave her without coverage.
As the fallout of the pandemic continues to reverberate through the healthcare system, concerns about healthcare access and affordability persist. The rapid disenrollment of millions from Medicaid is a stark reminder of these issues, highlighting the critical need for clear communication and effective administrative processes. Even as the country strives to return to a state of normalcy, the daunting challenge of ensuring comprehensive healthcare coverage for the most vulnerable citizens remains, underscoring the ongoing importance of Medicaid as a crucial safety net.
