Medicaid Unwinding

via Dorothy Mills-Gregg of Inside Health Policy:

While most states are reaching the height of their post-pandemic Medicaid renewals, Idaho is returning to nearly normal redeterminations, closing out the bulk of its pandemic eligibility unwinding after removing more than 121,000 Medicaid and CHIP beneficiaries the state deemed most likely ineligible from the programs in six months.

Hmmm...IHP's estimate is lower than that of KFF's daily tracker, which puts Idaho's total disenrollment number at 145,000 as of today.

Idaho’s Medicaid and Children’s Health Insurance Program enrollment grew by roughly 150,000 people during the pandemic’s continuous coverage requirement, maxing out at about 450,000 beneficiaries. An estimated 42% of the beneficiaries who were disenrolled lost coverage due to procedural or paperwork issues.

Yesterday the U.S. Census Bureau published new reports on Income, Poverty and Health Insurance Coverage in the United States as of 2022. Obviously all three of these are extremely important and interact closely with each other, but given that my focus is healthcare policy, I'm going to stick with the health insurance coverage portion.

According to the 2023 Current Population Survey Annual Social & Economic Supplement (CPS ASEC):

...92.1% of the U.S. population had health insurance coverage for all or part of 2022 (compared to 91.7% in 2021). An estimated 25.9 million or 7.9% of people did not have health insurance at any point during 2022, according to the 2023 Current Population Survey Annual Social and Economic Supplement (CPS ASEC). That compares to 27.2 million or 8.3% of people who did not have health insurance at any point during 2021.

It's been about five months since I last posted about the status of Oregon's pending Basic Health Plan program:

As reported by Megan Messerly of Politico in 2022:

In Oregon, Democrats passed a bill in March to establish a basic health program, the details of which are being ironed out by a task force that began meeting this week. In Kentucky, Republicans approved $4.5 million in state funds this spring to set up a basic health program, which was signed into law by the state’s Democratic governor. An estimated 85,000 Oregonians and at least 37,000 Kentuckians will be eligible to enroll in the plans as soon as next year.

I haven't checked in on how many Americans have lost Medicaid or CHIP coverage due to the ongoing Medicaid Unwinding process playing out nationally since the end of July. Fortunately, KFF (formerly the Kaiser Family Foundation) has been diligently tracking the data, and it continues to be extremely depressing and concerning.

At the time, "only" 3.77 million people had been confirmed to have lost coverage purely due to procedural/red tape reasons (as opposed to others who lost coverage after being determined ineligible any longer).

KFF's data is now pretty comprehensive (it includes nearly every state plus DC), and it's bad if not worse than many healthcare advocates feared as the numbers have continued to grow dramatically:

Over at Inside Health Policy, Amy Lotven has an excellent scoop from a new CMS report which was hiding in plain sight:

New CMS data, quietly released in late August, show about 178,000 consumers chose a qualified health plan (QHP) through a state or federal exchanges after losing Medicaid and CHIP coverage in the first two months of the Medicaid unwinding. Those sign-ups through the end of May are more than three times the 54,000 enrollments that CMS reported in July, which reflected only the April numbers.

via Access Health CT:

These free, in-person events will take place in Litchfield, New Britain, Vernon and Willimantic

HARTFORD, Conn. (Aug. 30, 2023) — Access Health CT (AHCT) can help eligible Connecticut residents enroll in HUSKY Health, the state’s Medicaid program, and Qualified Health Plans. To help residents understand the types of health coverage available to them, AHCT will host free, in-person enrollment fairs in September and October. Many HUSKY Health clients have been affected by “Medicaid Unwinding,” a term the federal government is using to describe the process of resuming reviewing households for Medicaid eligibility after a three-year break during the Public Health Emergency. The eligibility redetermination process resumed April 1 and HUSKY clients will be notified when it is their turn to enroll.

via the Centers for Medicare & Medicaid Services (CMS):

CMS Takes Action to Protect Health Care Coverage for Children and Families

• States must assess and fix their systems so eligible children and families can stay covered. 

Today, and as part of its ongoing work to make sure all Americans have access to health care coverage, the Centers for Medicare & Medicaid Services (CMS) sent a letter to all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands requiring them to determine whether they have an eligibility systems issue that could cause people, especially children, to be disenrolled from Medicaid or the Children’s Health Insurance Program (CHIP) even if they are still eligible for coverage, and requiring them to immediately act to correct the problem and reinstate coverage.

via Nevada Health Link:

• Medicaid recipients deemed ineligible for coverage may be eligible for financial assistance and are encouraged to contact Nevada Health Link to avoid a lapse in health coverage

CARSON CITY, Nev. – As the redetermination process associated with the unwinding of the Public Health Emergency continues, Nevada Health Link, Nevada’s health insurance marketplace, is continuing to work diligently to streamline the enrollment process for individuals and households whose increased income no longer qualifies them for Medicaid coverage.

It's been over six weeks since the last time I checked in on how many Americans had lost Medicaid or CHIP coverage due to the ongoing Medicaid Unwinding process playing out nationally. At the time, "only" 612,000 people had been confirmed to have lost coverage purely due to procedural/red tape reasons (as opposed to others who lost coverage after being determined ineligible any longer).

The Kaiser Family Foundation (KFF) has taken up the mantle on this front, and the data so far, while still limited, is pretty much as bad as many healthcare advocates feared. Since then, a lot more data has been collected and the numbers have grown dramatically:

via New York State of Health:

• Nearly Three Quarters of New Yorkers Enrolled in Medicaid, Child Health Plus or the Essential Plan Have Renewed Their Coverage by the June Deadline; Renewal Strategies Are Working; Others Still Have Time to Act

• New York Outperforming National Average as Reported by KFF

• Monthly Dashboard Tracks Renewal Status, Demographics, and State Program Transitions During Public Health Emergency Unwind  

ALBANY, N.Y. (July 18, 2023) – The New York State Department of Health today released the first issue of New York’s Public Health Emergency Unwind Dashboard, a monthly report reflecting data on renewal status, demographics, and program transitions for public health insurance enrollees, which shows renewal outreach strategies are working.  The report indicates that roughly 72 percent of New Yorkers enrolled in Medicaid, Child Health Plus or the Essential Plan renewed their coverage before the June deadline to re-enroll and those who haven’t still have time to act to avoid potential lapses in coverage. As reported by KFF, the national renewal rate for states reporting data is 59 percent.