Medicaid Unwinding Having Negative Unintended Consequences for Millions of Consumers

By Consumers for Quality Care, on December 13, 2023

From Kentucky to Utah, states are redetermining their residents’ eligibility for Medicaid, and according to KFF Health News, many consumers are being disenrolled from the program solely for procedural reasons. The result is that millions of patients nationwide are losing the only health coverage that they can afford.

A federal emergency declaration enacted during the COVID-19 pandemic prevented states from removing patients from Medicaid enrollment, even if they no longer met the program’s eligibility requirements. But when the public health emergency ended earlier this year, states were allowed to redetermine Medicaid eligibility. As a result, millions of Americans are losing their Medicaid coverage, with more than half losing coverage for no fault of their own. Many were dropped for reasons such as having incomplete paperwork or other clerical errors.

In states like Utah, policy experts and advocates are sounding the alarm. State officials there are reporting that nearly 30 percent of Utahns who lost Medicaid coverage this year are now uninsured. The report is offering insight into how the rest of the 11 million consumers nationwide who have lost Medicaid coverage because of these redeterminations may be faring. Without similar data for these states, it is difficult to know exactly how many consumers are now experiencing lapses in health care coverage. Reporting on how Medicaid redeterminations effect consumers has focused on individual cases.

In Kentucky, for example, Beverly Likens, a Medicaid patient, was days away from going into surgery to treat her chronic uterine bleeding. But then she learned that she lost her Medicaid coverage because the state processed her application incorrectly. Thankfully, she was eventually reinstated to Medicaid and able to have her surgery, but only after several delays and many exchanges with government health officials. Across the country, patients like Ms. Likens are being harmed unfair by this unfair Medicaid redetermination process.

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