How Many Pandemic-Era Medicaid Enrollees Will Lose Coverage?

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Almost 90% of people expected to have gained Medicaid coverage during the COVID-19 pandemic could get dropped from the program once the public health emergency ends, a new report finds.

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Federal law has prohibited states from removing beneficiaries from their Medicaid programs during the public health emergency. That, along with COVID-related job losses, has caused membership to remain higher than usual. However, 15 million new members risk losing coverage, once the federal government ends its emergency declaration, researchers at the Urban Institute said in a report released recently.

Modern Healthcare’s recent article entitled “Almost 90% of pandemic-era Medicaid enrollees at risk of losing coverage” says more than 9 million non-elderly adults and children enrolled in Medicaid between February 2020 and January 2021. By the end of this year, researchers believe enrollment will have grown by 17 million people compared with before the pandemic. That brings the total Medicaid membership to 76.3 million.

Of the estimated 15 million people who could lose coverage, 8.7 million are adults and 5.9 million are children. It’s thought that one-third of adults who lose coverage could qualify for subsidized private health insurance in Affordable Care Act marketplaces, and nearly all of the rest would have access to employer coverage in their families. Of the children losing coverage, 57% would be eligible for the Children’s Health Insurance Program, and another 9% would be eligible for subsidized coverage under the ACA.

State and federal policymakers will have to weigh both Medicaid members’ need to maintain coverage and the financial pressures facing state and local governments, Matthew Buettgens, a senior fellow at the Urban Institute, said in a statement on the findings.

“States can take actions to minimize unnecessary disenrollment and ensure that those losing Medicaid coverage know about their other coverage options, particularly marketplace coverage with premium tax credits,” he said.

Last month, the Centers for Medicare and Medicaid Services said it would give states a year after the public health emergency ends to complete their eligibility redetermining for Medicaid beneficiaries. That’s an increase from the previous six months. This will permit more time and flexibility.

The Urban Institute report notes that CMS could further help states, by encouraging them to extend changes made to their programs during the pandemic. Moreover, the report also urges Congress to maximize the number of people eligible for tax credits under ACA marketplace plans by making permanent the enhanced tax credits under the American Rescue Plan Act. It also says Congress should extend the enhanced federal match funds that go to states (federal medical assistance percentage) throughout next year, so they aren’t pressured to disenroll people. Enhanced FMAP is currently set to expire in March.

Expanding access to Medicaid boosts health outcomes, particularly among communities of color and those with lower incomes is critical, Avenel Joseph, vice president for policy at the Robert Wood Johnson Foundation, said in a statement. RWJF funded the report.

“Expanding access to affordable and comprehensive healthcare will significantly move the national closer to reducing long-standing racial and ethnic health disparities that were exacerbated by the pandemic,” she said.

Reference: Modern Healthcare (Sep. 15, 2021) “Almost 90% of pandemic-era Medicaid enrollees at risk of losing coverage”

Suggested Key Terms: Elder Law Attorney, Medicaid, COVID-19 (coronavirus)