Beginning in April, 2023 states will start removing millions of people from Medicaid as protections put in place early in the covid-19 pandemic expire. This action will put millions of people, especially low-income Americans, at risk of losing health coverage and potentially exposing them to large medical bills.
The finances of hospitals, doctors and others relying on payments from Medicaid will also be under pressure. Two main things that states need to make sure now are: not to disenroll people who are still entitled to Medicaid and connect the rest to other sources of coverage.
This will not be an easy task, as states have struggled to stay in contact with Medicaid recipients even before the Covid-19, who in some cases do not speak English, do not prioritize health insurance over more pressing needs, and lack a stable address or internet service.
With the rate of uninsured Americans at an all-time low, 8%, the course reversal will be painful. The Biden administration has predicted that 15 million people – 17% of enrollees -will lose coverage through Medicaid or CHIP, the closely related Children’s Health Insurance Program, as the programs return to normal operations. While many of the 15 million will fall off because they no longer qualify, nearly half will be dropped for procedural reasons, such as failing to respond to requests for updated personal information, a federal report said. (source: Millions on Medicaid may lose coverage as COVID protections expire (usatoday.com))
The unwinding will play out over more than a year.
People who lose Medicaid coverage – in the more than 30 states covered by the federal marketplace – will have until July 31, 2024, to sign up for ACA coverage, CMS announced on Jan. 27. It’s unclear whether the state-based marketplaces will offer the same extended open-enrollment period.
Even states that are taking far-reaching action to make sure people don’t end up uninsured worry the transition will be rough.