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Lindsey McNeil and her 7-year-old daughter, Noelle, who suffers from cerebral palsy and epilepsy, were shocked to receive an alert from the Florida Department of Children and Families late last month that Noelle would lose her Medicaid coverage 10 days later.
Since then, their lives have begun to fall apart, McNeil said. Noelle has stopped seeing the four therapists she visits each week and she is running out of the medications she needs to prevent her seizures from getting worse. Monday brought some relief: Ms. McNeil learned that Noelle’s coverage had been temporarily reinstated while they waited for a resolution to an appeal filed with the state.
“We have worked very hard to grow our family, our life and a home for this child,” Ms McNeil said. “It’s a little discouraging to think about what you might lose and what we might not be able to provide.”
Noelle was one of the most recent victims of the Reversal of a pandemic-era federal policy. that required states to keep people on Medicaid, the health insurance program that covers low-income Americans, in exchange for more federal funding. While the policy was in effect, enrollees were freed from regular eligibility checks. Enrollment in Medicaid and the Children’s Health Insurance Program rose to a record of more than 90 million, and the nation’s uninsured rate fell to historic lows.
But the politics expired at the beginning of April last year, allowing states to resume reducing their lists, and the so-called reduction process that followed has had far-reaching effects. More than 20 million Americans lost Medicaid at some point last year, according to KFFa nonprofit health policy research group, an unprecedented event in the nearly 60-year history of the joint federal-state program.
The disruption is not over yet. Only about 70 percent of renewal checks have been completed, according to Daniel Tsai, a top official at the federal Centers for Medicare and Medicaid Services, suggesting millions more people could lose coverage when the process concludes.
Below are some takeaways from the Medicaid reduction over the past year.
Many of those who lost coverage have not found an alternative.
In a poll Published Friday by KFF, nearly a quarter of adults who lost Medicaid during the cancellation said they were currently uninsured, while 70 percent of those who were removed from the program said they had ended up uninsured at least temporarily.
The Affordable Care Act markets, which recorded a record number of registrations by 2024, it provided shelter to some people. Edwin Park, a researcher at Georgetown University, pointed to recent federal data showing that about 25 percent of those who lost Medicaid had enrolled in marketplace plans.
Children have been especially affected.
More than half of the country’s children were covered by Medicaid or the Children’s Health Insurance Program before the reduction began, and the cost to that population has been steep.
Almost five million children have lost Medicaid so far, according to state data analyzed by Georgetown researchers. About two million of them have been in Texas, Georgia and Florida, and none of them have expanded the program under the Affordable Care Act.
Coverage losses have been seriously damaging even when temporary. In Richmond, Virginia, Trina King’s 12-year-old son Jerome, who has Down syndrome, went about two months without Medicaid late last summer and early fall. Ms King said the gap was the result of a series of delays in confirming Jerome’s eligibility after she moved and lost a renewal package. The mail had been sent to her old address even though she had notified the state that she had moved, Ms. King said.
Jerome, whose coverage was eventually reinstated, missed appointments with a list of specialists who accept Medicaid, including a spine doctor; an otorhinolaryngologist; a cardiologist; and a urologist, Ms. King said. During the coverage gap, her sessions with a home health aide had to be canceled. Ms. King postponed a post-surgical follow-up appointment that Jerome needed and also skipped some of her routine medical appointments.
Most people are being fired due to bureaucratic errors.
Like Jerome, about 70 percent of people who lost Medicaid were terminated for what were considered procedural causes, according to a KFF analysis of state data. Many people lost coverage after failing to return required documentation to a state Medicaid office, while others were accidentally fired due to technical glitches.
Hunter Jolley, a 33-year-old bartender from Little Rock, Arkansas, who makes about $19,000 a year, lost Medicaid last fall after renewal paperwork was mailed to a previous address. Max. Jolley, who uses the pronouns they and them, said they had failed to get coverage again despite requesting to return to the program three times.
“It’s all pretty scary,” Mx said. Jolley, adding that they had skipped medical and therapy appointments and reduced psychiatric appointments to once every three months, paying $270 out of pocket for them.
Those technical errors are due in part to how Medicaid is organized.
The different ways state Medicaid programs are set up help explain the different rates of procedural discharges, health policy experts said.
“People often think of a big Medicaid program when we talk about aggregate numbers, but the experience of people across the country, depending on which state they live in, has been very different,” said Tsai, the federal Medicaid official. .
Jennifer Tolbert, a health policy expert at KFF, said the reduction had exposed the country’s highly decentralized system of Medicaid administration, in which states use different technologies, some of them outdated and flawed.
Kelly Cantrelle, a top Medicaid official in Nevada, said the software used by the state to check eligibility had not been programmed to properly screen each member of a household, a problem that at one point led to children being expelled. Medicaid even if they were still eligible for it. The state contractor responsible for the software had to scramble to update it, she added.
Conducting enrollment checks has been a complex task even for large state Medicaid bureaucracies. Pennsylvania had about 6,000 full-time employees working on easing, said Hoa Pham, an official with the state Department of Human Services.
Some argue that cutting enrollment will return Medicaid to its intended scope.
Some health policy experts and state leaders have argued that Medicaid rolls needed to be reduced over the past year to preserve the program for those eligible for it.
Researchers at Paragon Health Institute, a conservative policy research organization, dear last summer that there were about 18 million people on Medicaid who were ineligible for coverage, costing the program more than $80 billion a year.
“Medicaid has eligibility requirements that are on the books,” said Drew Gonshorowski, a Paragon researcher who has written about the potential savings from trimming Medicaid rolls. “We should not expand coverage at random simply without making eligibility determinations. The program should work as planned.”
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