Medicaid Redeterminations Could Result in Hundreds of Thousands of Consumers, Including Children, Losing Health Coverage

By Consumers for Quality Care, on June 14, 2023

As pandemic-era policies expire, Medicaid redeterminations are beginning across the country. Early data on these redeterminations, according to reporting by The New York Times, show that hundreds of thousands of low-income consumers, children included, have lost their coverage under Medicaid.

What’s worse is that the majority of Medicaid enrollees – roughly two thirds – were not aware of these redeterminations, according to a survey conducted by the Kaiser Family Foundation (KFF). The survey was conducted around two months after states were able to begin Medicaid redeterminations.

Over a quarter of adults rely on Medicaid as their only source of health coverage, and redeterminations pose a major threat to these consumers who would have little or no access to quality affordable care without the program. But that’s what’s happening in the 19 states that have begun the redetermination process. In many cases, eligible residents are being removed simply because of bureaucratic paperwork issues.

If you fail to update your contact information, you can be removed. If you fail to actively renew your coverage after three years of continuous renewal, you can be removed. If you fail to report even small changes to your income, or changes to the size of your family, you can be removed from the Medicaid rolls. And if you’re removed, even for paperwork errors that aren’t your fault, appealing that decision and regaining your coverage is a process that can take months.

Many of those being dropped are children. “Those kids have nowhere else to turn for coverage,” said Joan Alker, Director of the Georgetown University Center for Children and Families “Medicaid is the single largest insurer for children. This is hugely consequential for them.”

CQC urges lawmakers and regulators to ensure that consumers do not face a lapse in healthcare coverage due to Medicaid redeterminations, particularly for those who remain eligible for Medicaid but are losing coverage due to procedural reasons.