A health care crisis is silently brewing across America.
Over 10 million people, including many children, have been abruptly cut off from critical health services in recent weeks, according to KFF, formerly known as the Kaiser Family Foundation, a nonprofit organization focusing on health care and health policy research and analysis.
This mass exodus of Medicaid participants constitutes nearly 10 percent of the over 90 million Americans who rely on the public health insurance program. And the numbers keep rising.
One-Third of Participants Cut as Pandemic Protections Expire
KFF data show that 35 percent of Medicaid participants with completed renewals were disenrolled by states. Texas, California, and Florida saw the most disenrollments at 1.2 million, 731,700, and 730,700, respectively. New York followed with nearly 650,000 cuts.
The cuts stem from provisions under the COVID-19 pandemic. The Families First Coronavirus Response Act mandated continuous Medicaid enrollment during the public health emergency, which ended in May 2023.
During the pandemic, between February 2020 and December 2021, Medicaid enrollment rose from 71.2 million to 86.7 million—a nearly 22 percent increase. The current cuts represent an unwinding as Medicaid returns to post-pandemic operations.
A Centers for Medicare & Medicaid Services (CMS) spokesperson told The Epoch Times the agency is committed to helping eligible people renew coverage and connecting ineligible people to new options.
“This includes urging states to adopt the many strategies put forward by CMS to make renewals easier for people, as well as CMS’ intensive monitoring and oversight efforts,” the spokesperson said, calling the agency’s response an “all-hands-on-deck effort.”
Is the Disenrollment Process Fair?
As many as 71 percent of Medicaid disenrollments are procedural; in other words, people lose coverage for not completing renewals.
Missed communications and moved addresses often lead to procedural disenrollment, Pavani Rangachari, a professor of health care administration and public health director of the Master of Healthcare Administration program at the University of New Haven in Connecticut, told The Epoch Times.
“States do not want to even give the benefit of the doubt, and [people] get automatically disenrolled,” Ms. Rangachari told The Epoch Times, noting that the most significant concern is how families, especially children, are affected.
“It’s a real public health crisis, [this] lack of insurance,” she added.
Are States Doing Anything to Prevent Disenrollments?
“Clearly, they’re not,” Ms. Rangachari said. She suggests automatic renewal policies and systems to verify eligibility as possible solutions.
She noted that some states have invested in infrastructure, automatic renewal, and continuous coverage. “[They] work with families and children to see if they, in fact, do not meet the eligibility requirement, to identify other options like [the Health Information Exchange] HIE under the Affordable Care Act,” Ms. Rangachari added. “You could have that option or at least ensure that the children are covered, usually with CHIP (Children’s Health Insurance Program).”
A significant number of those disenrolled are very sick and really need health insurance for primary and preventive care, according to Ms. Rangachari.
“Kicking them out of insurance denies them access to the most basic services, too,” she added. “It’s not just the expensive services.”
Access to primary and preventive care services is what ultimately keeps costs in check, Ms. Rangachari said. “Because these people are then going to cost the system a lot more in that very state that’s trying to deny them the coverage.”
A System Under Increasing Strain
Federal law restricts Medicaid/CHIP to citizens and legal immigrants. But ongoing southern border crossings strain hospital finances, as they’re required to treat uninsured people.
Some states, like California, use Medicaid programs to cover those who are in the United States illegally. California has a law that provides Medicaid coverage to children under 19 regardless of status but with qualifying income.
As of July 2023, 12 states and D.C. offer coverage to income-eligible children regardless of immigration status. Five states and D.C. also cover income-eligible adults irrespective of status.
Medicare also subsidizes hospitals’ uncompensated care costs through disproportionate share hospital payments. These don’t distinguish between citizens, legal or illegal immigrants. The health care cost burden alone was $23.1 billion in 2023, according to Federation for American Immigration Reform (FAIR) data.
Mass disenrollment amid surging inflation and health care burdens may test the system’s limits—and there may not be enough time to adapt.