State agencies across the nation have initiated a one-year process to reevaluate the financial eligibility of all Medicaid enrollees.
Medicaid is a joint state-federal health insurance program for people with low incomes or disabilities. Millions of adults and children, whose access to health care could be severely curtailed, are likely to be shocked by the results of this government paper-shuffle.
Medicaid Recipients Decrease Due To Ineligibility
Some Medicaid recipients are being dropped because they are no longer eligible, but preliminary data indicates that many are being dropped for procedural reasons, such as neglecting to complete forms.
Sixty-five percent of Medicaid enrollees questioned whether they could be removed from the program if they are no longer eligible or do not submit renewal forms, according to a study released this week by the non-profit health policy organization KFF.
It has been three years since Medicaid recipients actively participated in renewals; if you are currently enrolled, there are methods to protect your status.
KFF estimates that between 8 million and 24 million Medicaid recipients will be eliminated from the program in the coming months. The majority of Medicaid recipients will continue to receive coverage.
Early on in the COVID-19 pandemic, the federal government implemented a “continuous enrollment provision” that provided states with additional funding in exchange for a guarantee that the majority of beneficiaries’ coverage would continue regardless of changes in their income or other circumstances.
As part of the Families First Coronavirus Response Act, the program became effective in March 2020. This program expired on March 31, 2023, and in April, the 50 states launched a 12-month effort to reevaluate the financial eligibility of each of the nation’s nearly 95 million Medicaid recipients.
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Renewal Form
The problem is that the eligibility of millions of Medicaid recipients has changed, primarily due to variations in income. To maintain its full share of federal matching funds, each state must adhere to rules governing the “unwinding” of the pandemic-era expansion of Medicaid.
These rules are intended to ensure that states reevaluate recipients equitably. However, there are early indications that in addition to enrollees who have become ineligible, a significant number of enrollees are being terminated for reasons unrelated to their eligibility, a phenomenon known as “procedural terminations.”
According to Allexa Gardner, a senior research associate at Georgetown University’s Center for Children and Families, “we’re already witnessing some alarming situations.”
According to Arkansas Department of Human Services data, more than 28,000 infants and more than 72,000 children were withdrawn from the state’s Medicaid program in April.
Over 44,000 recipients were dropped because they “failed to return a renewal form”; only 5,414 Arkansans were deleted because their household income was above the threshold.
Similarly, according to a state report cited by the Orlando Sentinel, about 205,000 individuals in Florida were disqualified in the early weeks of the review because they neglected to respond to requests for information. According to the report, more than 80 percent of initial terminations were for procedural rather than eligibility reasons.
CHIP, or the Children’s Health Insurance Program, provides coverage for children whose families earn too much to qualify for Medicaid but cannot afford private insurance. Similar to Medicaid, CHIP is administered by states in accordance with federal requirements and with state and federal funding.
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