Curbing Medicaid Disenrollment and Protecting Vulnerable Populations

By Consumers for Quality Care, on November 29, 2023

During the COVID-19 pandemic, a now expired federal emergency declaration prevented states from removing patients from the Medicaid system, even if they no longer met the program’s eligibility requirements. But now, states are free to redetermine who is eligible for Medicaid, and millions of consumers are losing coverage, many through no fault of their own. Since the redetermination process began earlier this year, more than 10 million patients have been kicked off the Medicaid rolls, according to reporting by Healthcare Dive.

Some patients were disenrolled because their income increased between the start of the pandemic and this year, so much so that they were no longer eligible for the program. This was to be expected. Others, however, were disenrolled despite being eligible for the program. In these cases, otherwise eligible patients were kicked off Medicaid owing solely to administrative errors, paperwork issues, and other procedural reasons. In fact, it is estimated that 71 percent of all patients who were kicked off Medicaid were disenrolled for procedural reasons. The patients thus disenrolled include millions of low-income children who, without Medicaid, have no access to any other form of health care coverage.

Concerns are growing that the Medicaid redetermination process could cause a spike in the rate of uninsured Americans. Gaps in medical coverage can have negative effects on a consumer’s health and finances, and any loss in coverage for children could hurt their health and their development.

CQC urges lawmakers and regulators to ensure that consumers do not face any lapses in health care coverage due to Medicaid redeterminations.