A 2-year-old girl with cystic fibrosis is among the many Americans who lost Medicaid coverage after the pandemic. A toddler in Jacksonville, Florida, needed insurance to cover life-saving medications and doctor's visits, according to a lawsuit filed by the girl's mothers. Instead, when she became ill last year, her family made an expensive trip to the emergency room.
A Florida family says the crisis is spreading to communities across the country For millions of Americans, the nation's pandemic-era Medicaid expansion is coming to an end.
Some have turned to options like employer insurance plans and the Affordable Care Act. Some survived without insurance, avoided expensive doctor's visits and left prescriptions unfilled.
A new study on the impact of reintroducing Medicaid eligibility testing finds that nearly one in four people who lost Medicaid coverage last year remains uninsured. Nearly half of those kicked out of the program eventually became eligible again, suggesting they should never have been kicked out in the first place. And millions of people endure coverage gaps that can put their health at risk.
A KFF study found that 23% of Medicaid recipients remained without health insurance when states resumed eligibility screening last year. These people are more likely to struggle to pay their medical bills and delay medical appointments.
KFF, a nonprofit health policy organization, designed the study to find out how people are affected by eligibility testing for Medicaid, the federal health program for people with low incomes and disabilities. .
The federal government has provided billions of dollars in federal aid to states on the condition that they not exclude people from Medicaid until the COVID-19 emergency ends. When the public health emergency ended and eligibility testing resumed last April, states were allowed to conduct these tests at their own pace. Some states have accelerated testing, while others have been slower to administer tests. Two states, Oregon and Alaska, will not complete testing until early 2025.
KFF's national survey of more than 1,200 U.S. adults found that 19% of people enrolled in Medicaid during the pandemic had their enrollment temporarily or long-term discontinued.
Of those who were removed from Medicaid, 47% said they eventually became eligible for Medicaid coverage again. More than one in four adult girlfriends secure health insurance through an employer, the military, an Affordable Care Act insurance plan, or Medicare, the federal health care program for people age 65 and older. I am.
Even before the pandemic began, people were moving in and out of Medicaid as life circumstances changed, such as getting a job, losing a job or having children. What was unique about last year was that state Medicaid programs faced a huge number of eligibility tests at once, as the number of enrollees surged during the COVID-19 public health emergency. It was a process called reversion.
According to KFF research, 20.1 million Medicaid beneficiaries have been disenrolled since eligibility testing resumed a year ago.Another 43.6 million people have their insurance renewed and 30.4 million people are waiting for Medicaid renewal.
Jennifer Tolbert, deputy director of KFF's program on Medicaid and the uninsured, said most states should complete renewals by June. He said the federal Centers for Medicare and Medicaid Services, the federal agency that oversees Medicaid, will soon release estimates for when states will complete these pandemic-era reviews.
Tolbert said many people may have been mistakenly excluded from Medicaid. This would explain why so many people who were excluded were quickly added back into the public health insurance program. She said these removals had an impact because even a temporary loss of coverage could harm people.
The study found that 56% of people who lost Medicaid coverage did not seek medical care or delayed seeking care.
“This was a bigger problem for those who were disenrolled, creating disparities in access to the care they needed,” Tolbert said.
Alabama woman kicked out of Medicaid turns to Obamacare
Kayla Wildman, 31, of Alabama, became eligible for Medicaid insurance before giving birth to her first son in December 2020. Wildman, who lives in a small town southeast of Huntsville, said the insurance was comprehensive and helped her pay for doctor visits, medications and medical bills. She will be billed from the birth of her second child in 2022.
Last December, halfway through three months of treatment for hepatitis C, she was removed from Alabama's Medicaid program. She knew that without insurance, she wouldn't be able to afford to pay thousands of dollars for her medications.
“I was actually surprised,” Wildman said. “I couldn't afford to pay the full amount out of pocket, so I thought, 'What am I going to do?'”
Before getting pregnant with her first child, Wildman had insurance through her job at a local hospital. Before that, she tried to buy insurance through the Affordable Care Act, known as Obamacare, but the plan was too expensive.
When she lost Medicaid last November, she tried again and purchased a Blue Cross Blue Shield plan through the ACA Marketplace for $65 a month. KFF research found that 8% of people who were removed from Medicaid, like Wildman, secured new plans through the ACA, thanks to more generous pandemic-era subsidies that made monthly premiums more affordable. It turned out that it did.
My insurance paid for my treatment for hepatitis C, and I am now cured of the viral disease.
It also offers a wider choice of doctors compared to Medicaid.
“It's not so unaffordable that it's unaffordable,” she says.
Consumer advocates challenge Medicaid cuts
Consumer advocacy groups say many people lose Medicaid coverage due to incomplete documentation or other clerical errors. Renewing Medicaid will likely be the biggest bureaucratic effort in government health insurance coverage since the Affordable Care Act began expanding state Medicaid more than a decade ago.
Advocates say consumers face long wait times when seeking help from state Medicaid programs. Other patients, including some with disabilities, have difficulty accessing direct assistance, said Alicia Emanuel, senior attorney at the National Health Law Program in Los Angeles.
Medicaid enrollees have always faced these challenges, but renewal delays caused by the pandemic have exacerbated the problem, Emanuel said.
“These issues illustrate the cracks in the Medicaid system,” Emanuel said. “These are issues that advocates have been sounding the alarm on for years. We've just reached an inflection point with rollback.”
Lawyers representing Medicaid enrollees in Tennessee and Florida have filed lawsuits challenging both states for denying coverage to adults and children. Both lawsuits are pending.
The Florida class action lawsuit was brought by two mothers of two young children who allege the state failed to provide their families with adequate written notice before terminating coverage.
KFF's Tolbert said healthcare disruption is inevitable when so many people across the country have to renew their insurance. In many cases, those who purchase insurance through their employer or girlfriend's ACA Marketplace find that they are expected to pay a larger portion of their medical costs through deductibles and coinsurance.
“Many people who transition from Medicaid to other insurance express concerns about whether their new insurance will be able to cover the cost of their care,” Tolbert said.
Ken Alltucker is at @kalltucker in X. Email alltuck@usatoday.com..
