1 in 4 Medicaid cases during settlement, now uninsured

Nearly one in four adults who say they were “disenrolled” from Medicaid health care coverage as states unraveled a pandemic-era program are now uninsured, a new KFF poll shows.

So far, more than 20 million people, or 21% of enrollees, have been disenrolled from Medicaid as the program to keep people covered in health insurance during the pandemic is winding down, according to the latest data KFF has compiled from all 50 states and Washington. , DC Meanwhile, 43.6 million (46%) enrollees have had their coverage renewed and 30.4 million (32%) are awaiting their Medicaid renewal. This is evident from the latest data from KFF.

While those opted out by states have coverage options, including continuing to use Medicaid or enrolling in individual coverage under the Affordable Care Act, known as Obamacare, there are still people who are uninsured, KFF research shows.

“About one in five enrollees say they will be disenrolled from Medicaid coverage sometime in 2023 and about a quarter (23%) of those disenrolled remain uninsured,” says KFF said in its analysis of the survey data published Thursday. “Some of those who disenrolled eventually re-enrolled in the program (47%) or found other forms of health care coverage (28%), but the loss of coverage left many concerned about both their physical health as well as their mental health.”

The KFF report comes nearly a year after the Biden administration in May 2023 ended the U.S. public health emergency, which had pushed the number of Americans covered by Medicaid to record highs in the three years that followed the temporary pause in Medicaid realignments.

In response to the Covid-19 outbreak the Families First Coronavirus Response Act was signed into law by then-President Trump on March 18, 2020. That law included a “provision that required state Medicaid programs to keep people enrolled in exchange for additional federal funding,” according to KFF.

But since the end of the public health emergency last May, states are once again conducting Medicaid redetermination processes. Medicaid redetermination, also called Medicaid renewal or Medicaid recertification, essentially occurs when people are asked to prove their eligibility for such coverage and is now more commonly referred to as “Medicaid settlement.”

In an effort to gauge the experiences of people trying to renew their coverage, KFF interviewed more than 1,200 adults who had Medicaid before April 1, 2023. When they lost coverage, KFF researchers found several reasons why people lost coverage: including costs.

“The cost of health insurance is also a major concern for those who now have other forms of coverage,” the KFF analysis said. “Of those who now have other forms of coverage (8% of enrollees), half (50%) say they are concerned about paying their monthly premium, and three-quarters (76%) say they are concerned on paying the costs of health care services. Most who have another source of coverage say it is about the same or better than Medicaid in terms of access to care.”

Health insurers that help states manage their Medicaid programs have been working to get them to re-enroll in their coverage or enroll in Obamacare.

Health insurers including Centene, Elevance Health, UnitedHealth Group and others with large Medicaid businesses will report their first-quarter earnings in the coming weeks and will likely report whether their businesses have been affected by decisions not to re-enroll in Medicaid or other forms of health care coverage.