Throughout the COVID-19 public health emergency, the U.S. federal government allowed Medicaid participants to keep their health coverage. Once the emergency ended, states resumed the regular checks to determine who qualifies for Medicaid. By early February 2023, states were evaluating the eligibility of approximately 87 million people on Medicaid, and by June, they began removing individuals from the program. By the end of July last year, nearly 3.8 million had been dropped from Medicaid coverage.
More than 20 million people lost healthcare insurance so far
Estimations indicated that about 15 million could lose their Medicaid benefits during these checks. Yet, a recent Kaiser Family Foundation report reveals a higher number, stating that over 20 million individuals had been removed from Medicaid by April 11, 2024, according to the latest figures from all 50 states plus the District of Columbia. The largest numbers of those no longer on Medicaid are from highly populated states such as California, Texas, and Florida, followed by New York, Pennsylvania, and Massachusetts.
The changes
This change represents a significant departure from policies during the pandemic, which featured automatic renewals to minimize health care interruptions. Starting this year, Medicaid users must reapply to keep their coverage, and many have found themselves without the health care they depended on for years. The likelihood of being dropped typically varied with the state’s population size.
The top 10 states
Texas, California, and Florida disenrolled a total of 5.1 million people, with each contributing to the report with 2.1 million, 1.6 million and 1.4 million respectively. In New York, a total of 1.4 million were disenrolled, in Pennsylvania 848,400, Massachusetts 750,000; Ohio 707,000; Oklahoma 690,000; Michigan 867,000; and Arizona 611,000. Wyoming, Alaska, Vermont and the District of Columbia reported some of the smallest disenrollments, at between 5,000 and 30,000.
Read also: The California system is overwhelmed by migrants and homeless: “Everything is already full…”
The numbers
According to a survey published on April 12, nearly one-fourth of adults who were removed from Medicaid now have no health insurance. This report sheds light on the challenges faced by many Americans in maintaining their coverage through the government’s low-income insurance program after the expiration of pandemic-related protections last spring.
The survey, which was the first national review of adults assessed for Medicaid eligibility during this period, found that nearly half of those who lost their coverage managed to re-enroll in the following weeks or months. This suggests that many of these individuals should not have been dropped from coverage initially.
Of those surveyed, 23% are now without any insurance, while another 28% have secured alternative coverage through sources such as employer plans, Medicare, the Affordable Care Act’s marketplace, or military health services, according to the findings from the health research organization KFF.
State by state variations
While population size played a significant role in Medicaid disenrollments, other factors were also at play. In Southern states like Texas and South Carolina, disenrollments were often due to stricter state-specific eligibility criteria. For example, Texas removed approximately 2.1 million people from Medicaid, managing to retain 1.9 million, with a significant number of those disenrolled being children. In Texas alone, about 65 percent of those who lost coverage were children.
How states respond
The healthcare situation in Texas is notably difficult, as explained by Chris Fong, CEO of Smile Insurance Group, in an interview with Newsweek. Many individuals in Texas struggle without health insurance because, although they qualify for Medicaid, they are ineligible unless they have a dependent child under 18. This makes reinstating coverage more challenging in Texas compared to other states.
Conversely, states like New York are taking measures to broaden eligibility for Medicaid and related programs. New York, for example, boasts one of the highest eligibility caps for the Children’s Health Insurance Program (CHIP), allowing for coverage up to 400 percent of the poverty level. CHIP is a joint state and federal initiative providing health insurance to children from families who earn too much to qualify for Medicaid but too little for private insurance.
Furthermore, New York has expanded its Basic Health Program, now covering adults with incomes up to 250 percent of the poverty level. This expansion is substantial compared to many other states, providing an alternative for those who might not qualify for Medicaid this year.
