Procedural Reasons Responsible for Many Losing Medicaid Amidst Unwinding

The end of continuous Medicaid enrollment due to COVID-19 is projected to cause significant coverage losses nationally as states recertify eligibility for Medicaid and the Medicare Savings Programs (MSPs). The U.S. Department of Health and Human Services (HHS) estimates as many as 15 million people could lose coverage as states resume regular operations.

Some will no longer be eligible for Medicaid due to changes in circumstances that bar them from qualifying for benefits. But even those who still qualify may lose coverage. Their access will be at risk due to burdensome administrative processes they will need to comply with to stay enrolled. Many may not know the rules are changing, or how to comply. A recent KFF survey shows 65% of Medicaid enrollees are unaware that their states are or will be restarting eligibility redeterminations. Nearly half, including 68% of those 65 and older, have never been through a redetermination process, and one-third have not provided updated contact information to their states, which could lead to their states being unable to contact them to gather eligibility information.

States are operating on various timelines for ending continuous eligibility but an analysis of the early data, also from KFF, reveals over 550,000 people across 12 states have lost Medicaid coverage since the unwinding of the continuous enrollment protections began. Alarmingly, procedural reasons rather than loss of eligibility are the prime driver of disenrollment in many of these states. In Florida alone, nearly 250,000 people lost coverage as of May, and 82% were disenrolled for procedural reasons. This is especially concerning given that only 35% of enrollees say they had a change that would make them ineligible for Medicaid.

At Medicare Rights, we urge states and HHS to redouble plans to contact people with Medicaid to ensure they know about the state’s redetermination process and their responsibilities. We appreciate recent efforts on oversight and accountability. As the redeterminations continue, we recommend that states and HHS engage in targeted outreach about major timelines and tasks, including the importance of applying for an MSP, how to update one’s contact information, and when to monitor for vital state communications. We also urge states to delay disenrollment where possible to give enrollees more time to respond given the novelty of the situation, the high incidence of confusion, and the likelihood that many of those who have not completed their paperwork are still eligible for coverage.  

Read the KFF analysis of early Medicaid unwinding data.

Read the KFF survey about Medicaid enrollee knowledge of Medicaid unwinding.

Read more about Medicaid unwinding.