States will begin culling their Medicaid rolls on Saturday, kickstarting a redeterminations process that could result in 15 million low-income Americans losing healthcare coverage over the next year.
Medicaid enrollment skyrocketed during the pandemic, partially due to COVID-19 era rules requiring states to provide continuous enrollment to Medicaid beneficiaries in exchange for more generous federal funding. But many states earlier this year resumed eligibility checks, and starting April 1, are once again allowed to disenroll Medicare beneficiaries from the health insurance program.
The CMS has estimated that some 15 million of the 92 million people currently enrolled in Medicaid will lose coverage during redeterminations.
As early as Saturday, five conservative-led states — Arizona, Arkansas, Idaho, New Hampshire and South Dakota — will begin disenrolling Medicaid members for procedural reasons, like not responding to a renewal form, according to the CMS.
Fourteen states will begin disenrollments in May, while 21 states and Washington, D.C. plan to begin in June. Nine states will resume redeterminations for procedural reasons in July. Oregon is waiting until October.
States are taking differing approaches to redeterminations, a process that will be closely watched due to its potential to have major ramifications for health insurance coverage in the U.S.
Of the 15 million projected to lose coverage, seven million are expected to lose coverage due to administrative churn like incorrect paperwork or missed notices. Many states are also struggling with a workforce shortage among state Medicaid staff, which could hamstring beneficiaries’ ability to renew.
Redeterminations are also expected to roil health insurers’ rolls, especially those with a heavy footprint in Medicaid markets like Molina and Centene. However, major payers have said that despite heavy projected Medicaid losses, they expect to recapture members in their marketplace plans.
The CMS has said that the expiration of the continuous coverage requirement is the single largest health coverage transition event since the first open enrollment period of the Affordable Care Act.
Read more below on its wide-ranging implications for the healthcare sector.
