JEFERSON CITY, Mo. (AP) — The United States’ leading health official made a passionate appeal to states, urging them to take greater action in ensuring that lower-income individuals remain enrolled in Medicaid. This plea comes as the Biden administration released data on Friday confirming that many individuals who had health coverage during the pandemic are now losing it.
While a decrease in Medicaid coverage was anticipated, health officials are expressing concern over the significant number of people being removed from the program due to their failure to submit required forms or adhere to specific procedures.
In April, 18 states initiated a post-pandemic review of their Medicaid rolls, resulting in continued health coverage for approximately 1 million recipients, but termination for 715,000 others. The recently published data from the federal Centers for Medicare and Medicaid Services revealed that 4 out of 5 of those dropped were due to procedural reasons.
On Friday, Health and Human Services Secretary Xavier Becerra took action by sending a letter to all governors, urging them to enhance their efforts in retaining individuals on Medicaid. In the letter, he specifically encouraged the utilization of electronic data from other federal programs, like food stamps, to automatically verify people’s eligibility for Medicaid. This approach would eliminate the necessity of mailing and returning physical documents, streamlining the process and potentially preventing unnecessary drops from the Medicaid rolls.
“I am deeply concerned about the high rates of procedural terminations and the burdensome ‘red tape’ and paperwork issues that contribute to them,” Health and Human Services Secretary Xavier Becerra expressed to governors.
During the pandemic, states were barred from terminating people’s Medicaid coverage, leading to a significant surge in Medicaid enrollment, growing from 71 million individuals in February 2020 to 93 million in February 2023. However, this prohibition on trimming rolls ended in April, and states have now resumed the annual eligibility redeterminations that were required before the pandemic.
The recently released federal data only covers the first month of state Medicaid reviews from the states that acted most promptly. Since then, additional states have also submitted reports on individuals who had their Medicaid renewed or terminated in May and June.
Though the government hasn’t yet released data from the most recent reports, information gathered by The Associated Press and health care advocacy groups indicates that around 3.7 million people have already lost Medicaid coverage. Notably, this includes approximately 500,000 in Texas, around 400,000 in Florida, and 225,000 in California. According to the AP’s data, 89% of those who lost coverage in California did so for procedural reasons, while the figures were 81% in Texas and 59% in Florida.
According to Michelle Levander, the founding director of the Center for Health Journalism at the University of Southern California, many of the people who lost Medicaid coverage might still have been eligible for it. However, they find themselves entangled in a bureaucratic nightmare due to confusing forms, notices sent to incorrect addresses, and other administrative errors.
Officials from the Centers for Medicare and Medicaid Services (CMS) have been working with several states to address these issues, leading to the voluntary slowing down of Medicaid removals in some states.
For instance, South Carolina took measures to improve its procedures and reported renewing Medicaid coverage for approximately 27,000 individuals in May, while removing 118,000. The majority of those dropped, about 95%, lost coverage due to procedural reasons. In June, South Carolina extended the eligibility renewal deadline from 60 days to 90 days, resulting in no removals from Medicaid during that month.
Michigan also made efforts to retain Medicaid recipients by renewing coverage for over 103,000 individuals in June and removing only 12,000. The state chose to delay terminations for those who did not respond to renewal requests and instead increased outreach attempts. Consequently, more than 100,000 people had incomplete eligibility cases in June.
Although people who are dropped from Medicaid have a chance to regain coverage retroactively by submitting eligibility proof within 90 days, some advocacy groups argue that this process still poses challenges for many individuals.
“State government is not necessarily nimble,” remarked Keesa Smith, the executive director of Arkansas Advocates for Children and Families. She expressed concern about the lack of a fast track to reinstate individuals who have been disenrolled from Medicaid.
Arkansas officials have been at the forefront of defending Medicaid cuts, arguing that many individuals might not return the required forms because they no longer need Medicaid. According to Arkansas Medicaid Director Janet Mann, people might be “transitioning off of Medicaid” because they have found employment, are earning higher incomes, and now have access to health care through their employers or the federal marketplace. She believes that this should be seen as a positive development rather than criticized.
Insurance companies responsible for running Medicaid programs in various states are taking steps to reduce procedural terminations and actively working to enroll people in new plans. For instance, the Blue Cross-Blue Shield insurer Elevance Health reported losing 130,000 Medicaid customers during the recently completed second quarter due to Medicaid eligibility redeterminations. However, the company’s Chief Financial Officer, John Gallina, mentioned that many people lost Medicaid coverage due to administrative reasons and are likely to reenroll in the near future.
During a discussion with analysts on Thursday, leaders of the insurer Molina Healthcare disclosed that the company experienced a loss of approximately 93,000 Medicaid customers in the recently completed second quarter, primarily due to eligibility redeterminations. Molina officials mentioned that they are actively working to transition those who no longer qualify for Medicaid to one of the individual insurance plans they offer through state-based marketplaces.
Federal data for April revealed that some states handled the surge of inquiries regarding Medicaid coverage better than others.
In 19 states and the District of Columbia, the average wait time for Medicaid call centers was one minute or less in April. However, in Idaho, callers to the state’s Medicaid help line faced an average wait of 51 minutes. Similarly, in Missouri, the average wait time was 44 minutes, and in Florida, it was 40 minutes.
