Medicaid Set to Drop 14 Million from Program Under New Rules

Americans receiving health care coverage through Medicaid may risk losing coverage over the next year

Around 84 million people receive medical coverage through the government-sponsored program. The Medicaid program has grown by 20 million people since January 2020, before the Covid-19 pandemic. 

As states begin checking individuals’ eligibility for Medicaid, as many as 14 million people could lose access to health care. State eligibility checks will take place for the first time in three years. 

At the pandemic’s start, the federal government forbade states from kicking people off Medicaid, even if they had become ineligible. Before the pandemic, people would frequently lose their Medicaid coverage if they began earning too much money to qualify for the program, moved to a new state, or started receiving health care coverage through their employer. 

The ability to drop coverage for individuals halted once Covid-19 began spreading nationwide. 

Over the upcoming year, states will again be required to start rechecking eligibility of every person on Medicaid. People must fill out forms to verify their personal information, including income, household size, and address.

Requirements will vary depending on the state in which a person lives. Some states, including Arkansas, Iowa, Ohio, Florida, Idaho, New Hampshire, West Virginia, Arizona, and Oklahoma, are among the states that will start removing ineligible recipients as soon as May. Other states will start to remove from Medicaid rolls in May, June, or July.

However, not everyone will be removed all at once. States will continue to verify eligibility over periods of nine months to one year. 

Options remain for individuals who lose their Medicaid coverage

Individuals who don’t qualify for Medicaid coverage can look to the Affordable Care Act’s marketplace for possible coverage. However, the coverage available will be substantially different from what Medicaid offers. Co-pays and out-of-pocket expenses are frequently higher.

Additionally, individuals must check if insurance plans offered in the marketplace will cover the doctors they use. 

A special enrollment period will open for unenrolled individuals from Medicaid and will begin on March 31 and last through July 31, 2024. Disenrolled people have 60 days to enroll after losing coverage, according to guidance from the Centers for Medicare and Medicaid Services provided to states last month. 

More than half of the children in the U.S. receive health care coverage through the Children’s Health Insurance Program or Medicaid. Even if a notice is received by the guardian of a child that they are no longer eligible, it remains likely the child still qualifies for health care coverage through the program or CHIP, which covers children whose families don’t earn enough to afford private health insurance but make too much money to qualify for Medicaid. 

According to estimates from the Georgetown University Health Policy Institute’s Center for Children and Families, between 80 and 90% of children will remain eligible for the programs. 

According to Joan Alker, the policy center’s executive director, “When a parent receives a message that they aren’t eligible anymore, they often assume their child is no longer eligible either. It’s more common to find that the parent is no longer eligible for Medicaid, but the child still is.”