Medicaid Access Could Be Lost to Millions Come April — Here’s Why

Happy doctor talking to senior male patient while being in a home visit.
Drazen Zigic / Getty Images/iStockphoto

The $1.7 trillion spending bill currently being considered by Congress could threaten Medicaid coverage for millions of Americans who enrolled in the health insurance program during the COVID-19 pandemic.

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The pending legislation, which needs to pass by Friday to prevent a government shutdown, will sunset a COVID-era requirement that prohibited states from kicking certain recipients off Medicaid, the AP reported.

The legislation comes as the Biden administration faces increasing pressure to declare an end to the COVID health emergency. Earlier this week, 25 Republican governors signed a letter to the president requesting that he make the declaration, citing high Medicaid enrollment as one of the reasons.

“This is a positive for states in terms of planning, however, [it] will come at the cost of some individuals losing their health care,” Massey Whorley, a principal at health consulting firm Avalere, told the AP.

Medicaid is the federal insurance program for low-income households. More than 80 million are enrolled in the program and nearly 90 million are enrolled in both Medicaid and Children’s Health Insurance Programs, as GOBankingRates recently reported. Enrollment in Medicaid surged 30% during the pandemic after Congress barred states from booting people out of the program for the duration of pandemic, CNBC reported.

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The spending bill now being mulled by lawmakers includes a provision that would eliminate Medicaid coverage protections enacted during the pandemic. If the bill passes, states could start terminating recipients’ coverage in April 2023 if they no longer meet the program’s eligibility criteria.

“As of April 1, Medicaid agencies conducting redeterminations for people enrolled in the program can result in a termination of Medicaid coverage,” Jack Rollins, director of federal policy at the National Association of Medicaid Directors, told CNBC.

The COVID public health emergency was first declared in January 2020 and has been renewed every 90 days since then. If Medicaid protections granted by the declaration end, an estimated 15 million people will lose coverage, according to an August report from the U.S. Department of Health and Human Services.

If that happens, those affected will have to look for other coverage options.

“It’s important to contextualize that Medicaid coverage loss doesn’t necessarily mean health insurance coverage loss,” Rollins said. “Many of those folks will be transitioning to other sources of coverage.”

As the AP noted, many will be eligible for health insurance coverage through employers, the Affordable Care Act or the CHIP.

The challenge for states, which administer Medicaid, is tracking down all of the recipients who might see their coverage end in April. Many of the nation’s poorest people don’t have stable home address or access to internet or phone services to check their status.

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Meanwhile, the U.S. Senate is expected to vote on the spending bill first. Democrats will try to gather support from at least 10 Republican senators to pass the measure before sending it to the House.

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About the Author

Vance Cariaga is a London-based writer, editor and journalist who previously held staff positions at Investor’s Business Daily, The Charlotte Business Journal and The Charlotte Observer. His work also appeared in Charlotte Magazine, Street & Smith’s Sports Business Journal and Business North Carolina magazine. He holds a B.A. in English from Appalachian State University and studied journalism at the University of South Carolina. His reporting earned awards from the North Carolina Press Association, the Green Eyeshade Awards and AlterNet. In addition to journalism, he has worked in banking, accounting and restaurant management. A native of North Carolina who also writes fiction, Vance’s short story, “Saint Christopher,” placed second in the 2019 Writer’s Digest Short Short Story Competition. Two of his short stories appear in With One Eye on the Cows, an anthology published by Ad Hoc Fiction in 2019. His debut novel, Voodoo Hideaway, was published in 2021 by Atmosphere Press.
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