Black and Latino Medicaid enrollees have been twice as likely as white enrollees to lose Medicaid coverage due to an inability to complete renewal forms over the past year, researchers concluded in a published paper. in JAMA Internal Medicine online June 3. Article, “Racial and Ethnic Disparities in Medicaid Disenrollment Following the End of the COVID-19 Public Health Emergency,” was written by Kranti C. Rumalla, Daniel B. Nelson, MD, K. John McConnell, Ph.D. and Jane M. Zhu, M.D.
“Continued Medicaid enrollment during the COVID-19 public health emergency (PHE) led to record enrollment of 94 million people and a decline in uninsurance,” the authors wrote. “Since the continuous enrollment provision ended on March 31, 2023, approximately 10 million people have lost Medicaid coverage as states began to redetermine enrollees’ Medicaid eligibility (rescission period). Three-quarters of disenrollments occurred for procedural reasons, including incomplete applications, application errors, and inaccurate contact information.”
As The New York Times‘s Noah Weiland wrote on June 3, “The findings from researchers at Oregon Health and Science University, Harvard Medical School and Northwestern University are some of the first comprehensive data on race collected after a US-era policy ended last year. the pandemic that allowed Medicaid beneficiaries to maintain their coverage without regular eligibility checks. year. More than 22 million low-income people have lost health care coverage at some point since April 2023, when the policy allowing continuous enrollment expired. The process of ending that policy (what federal and state officials have called ‘dismantling’) was one of the most dramatic breaks in the health safety net in a generation.”
“Medicaid eligibility is complex, and then applying for and maintaining Medicaid coverage is a huge logistical barrier,” Dr. Jane M. Zhu, an associate professor of medicine at Oregon Health and Science University and a of the authors of the study. interview. “What this analysis shows is that these barriers have secondary effects on particular communities.”
A provision in a coronavirus relief package passed by Congress in 2020 required states to keep beneficiaries of the joint federal-state health insurance program for the poor continuously enrolled in exchange for additional federal funding. As of early 2023, more than 90 million people were enrolled in Medicaid and the Children’s Health Insurance Program, or more than one in four Americans. That number was up from the roughly 70 million people at the start of the coronavirus pandemic. About half of Medicaid enrollees are black or Latino, and about 40 percent are white.
State-level data on the causes of these casualties is not widespread, and only nine states currently report casualties by race and ethnicity, the authors noted. To overcome this, they used publicly available data from the US Census Bureau’s Household Pulse Survey, conducted between March 29 and October 2, 2023, to estimate adult disenrollment in Medicaid by race and ethnicity during the Medicaid disenrollment period. The findings revealed that people who identified as Black and Hispanic were twice as likely as white people to report losing Medicaid coverage due to difficulties completing the renewal process.
As of May, Medicaid enrollment had declined by more than 13 million, including more than five million children, according to the Georgetown University Center for Children and Families, a unit within Georgetown University’s McCourt School of Public PolicyThe Center for Children and Families noted that “as of March 2023, more than 35.1 million children were enrolled in Medicaid and approximately 4.3 million were enrolled in CHIP-funded Medicaid coverage—more than half of all American children. Children are eligible for Medicaid coverage, or for coverage in the state’s standalone CHIP program, at much higher family income levels than adults, so they are more likely to remain eligible during the disenrollment process. However, children are also more likely to be disenrolled for procedural reasons and experience gaps in coverage before re-enrolling in Medicaid. Because children of color make up a disproportionate share of Medicaid enrollees and may face additional barriers to maintaining coverage, disenrollments can widen racial and ethnic disparities in health insurance coverage and restrict access to health insurance. attention. Last year, CCF estimated that up to 6.7 million children could experience a period of uninsurance as a result of cancellation.”
Additionally, the Center for Children and Families noted, “CCF researchers are tracking changes in Medicaid enrollment during the disenrollment process to monitor health coverage losses for children. To capture near real-time data, CCF uses enrollment data posted by states on their websites because that data is generally more timely than federal sources. However, not all states publish enrollment data. Some states may publish additional data, such as disenrollments, in specific disenrollment data reports or state dashboards, but the map and charts below do not include those other data sources. The Centers for Medicare and Medicaid Services (CMS) also releases monthly state enrollment figures with a lag of several months. We use CMS enrollment data for states that do not publish their own data directly when available.”
Authors of the new study urge policymakers to improve Medicaid enrollment processes to address health disparities, through transparent reporting of racial and ethnic data, streamlined administrative procedures, expanded renewal assistance, and priority redeterminations for beneficiaries most likely to be ineligible.
“Addressing these barriers may include more transparent reporting of racial and ethnic data, expedited administrative processes, expanded renewal assistance, and priority redeterminations for beneficiaries most likely to be ineligible,” the researchers wrote.
