More than 3.6 million people disenrolled from Medicaid

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At least 3.6 million Medicaid enrollees have been disenrolled as of July 24, according to KFF data from 37 states and the District of Columbia.

Thirty-seven percent of people with a completed renewal were disenrolled in reporting states while 63%, or 5.4 million enrollees, had their coverage renewed, KFF said. Because not all states have publicly available data on total disenrollment, KFF data undercounts the actual number of those who have lost Medicaid coverage.

There is wide variation in disenrollment rates across reporting states, ranging from 82% in Texas to 10% in Michigan, the report said. Some states, such as Texas, initially targeted people early in the unwinding period but other states are conducting renewals based on an individual's renewal date, KFF said.

KFF said that some states have adopted several policies that promote continued coverage among those who remain eligible and have automated eligibility systems that can more easily and accurately process renewals, while other states have adopted fewer of these policies and have more manually-driven systems.

WHY THIS MATTERS

The Centers for Medicare and Medicaid Services has been cracking down on states the agency has found to be in noncompliance with federal requirements concerning redeterminations.

Last week, CMS announced it had paused procedural terminations in at least half a dozen states, but it did not name the states. Since the start of this year, CMS has taken action to require states to comply with federal requirements and to fix problems and systems issues, the agency said. 

In addition, these states were reportedly required to reinstate any enrollees that had been improperly terminated. This added up to tens of thousands of people being reinstated to Medicaid following CMS intervention, according to CMS Deputy Administrator Dan Tsai, who is director of the Center for Medicaid & CHIP Services. 

THE LARGER TREND

States began the redetermination process on April 1, ahead of the end of the public health emergency on May 11.

During the COVID-19 public health emergency, Medicaid numbers grew due to the continuous enrollment requirement that kept people covered. 
State funding for the Medicaid program was enhanced by federal funds during the PHE. But the Consolidated Appropriations Act, 2023 phased down the enhanced federal Medicaid matching funds through December of this year, according to KFF.

The loss of coverage for Medicaid recipients happened faster than anyone believed it would, Karen Shields said last month. Shields is chief client engagement officer at Gainwell Technologies, a large payer of Medicaid claims and the former deputy director of the Center for Medicaid and CHIP Services.

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org