18M projected to lose Medicaid coverage at end of COVID-19 emergency

Dive Brief:

As many as 18 million enrollees stand to lose Medicaid coverage when the COVID-19 public health emergency ends, according to a new analysis from the Robert Wood Johnson Foundation.
Many people who are currently enrolled in Medicaid will transition to other coverage options, but 3.8 million people will completely lose coverage, the report projected. Nineteen states are expected to see their uninsured rates spike by more than 20%.
The researchers also projected that 3.2 million children will transition from Medicaid to separate Children’s Health Insurance Program health plans.

Dive Insight:

The Families First Coronavirus Response Act’s continuous coverage requirement prevents state Medicaid agencies from removing people from the program during the COVID-19 public health emergency. But when the declaration of the federal emergency expires, now set for April 2023, states will resume normal eligibility determinations, a process that is expected to push millions of people out of the program.

Health policy experts have continuously sounded the alarm about the impending disruption of coverage for so many people, warning that the unwinding of the policy could severely reduce patient care.

The RWJF said the end of the COVID-19 public health emergency will herald the largest health coverage changes since implementation of the Affordable Care Act. The foundation urged state Medicaid officials and policymakers to ensure that current enrollees are aware of the approaching end of the public health emergency and have a plan to maintain or find new health coverage through their employer, the federal healthcare marketplace or Medicaid.

RWJF's projections for the number of Medicaid enrollees who could lose their coverage exceed the HHS' own forecast in August pegging the number at 15 million, or 17% of those now enrolled in Medicaid or CHIP.

Loss of eligibility will require 9.5% of beneficiaries to transition to another source of health insurance, while nearly 8% will leave the program despite remaining eligible due to difficulty navigating the renewal process and other administrative issues, the HHS said at the time.

The agency said it was working to reduce the risk of people losing insurance coverage at the end of the emergency. Those efforts include coordinating with state and federal marketplaces to facilitate enrollment in other coverage options, and increasing outreach and education efforts.

A number of insurers are focused on offering marketplace plans, and the impending rollback of pandemic protections will test their abilities to shift Medicaid members who lose coverage to subsidized versions of the private plans.