[Largest Concentration of Health Insurance Loss in US History ]
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ROLLING MEDICAID PURGE  
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Jake Johnson
September 8, 2023
Common Dreams
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_ Largest Concentration of Health Insurance Loss in US History _

Families gather for resources, including Medicaid eligibility and
enrollment information, on April 27, 2023 in Springfield, Virginia.,
Jahi Chikwendiu/The Washington Post via Getty Images)

 

States across the U.S. have stripped nearly 6 million people of
Medicaid coverage over just the past several months, creating what one
healthcare activist and researcher described as "the largest
concentration of health insurance loss in American history."

"This is happening in red states like Texas, Utah, or Idaho, where we
expect this brutal Medicaid retrenchment," Beatrice Adler-Bolton,
co-author of " Health Communism
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co-host of the popular "Death Panel
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on Friday.

"But there are huge amounts of procedural disenrollments happening in
California. It's happening in Rhode Island and California and New
Mexico," noted Adler-Bolton. "This is a year-long process, and it's
just getting started. It's moving slowly, and it's more dangerous this
way. This process is rolling, so the data is slow. We're not going to
have a full picture of how to compare states against each other for
months and months."

The latest data
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compiled by KFF—which includes publicly reported figures from 48
states and Washington, D.C.—shows that at least 5.7 million people
have lost Medicaid coverage since April, when states began eligibility
checks and disenrollments that were paused during the coronavirus
pandemic.

A bipartisan deal reached
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by Congress and approved by President Joe Biden late last year lifted
the pandemic-era continuous coverage requirements that prevented
states from kicking people off Medicaid during the public health
emergency. The policy led to record
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Medicaid enrollment, and its termination could cause upwards of 15
million people
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millions of children—to lose coverage under the program.

According to KFF, 73% of the people disenrolled from Medicaid so far
have lost coverage for procedural reasons—such as a failure to
return paperwork on time or jump through other, often confusing,
bureaucratic hoops—not because they were deemed ineligible due to
their income or other factors.

"High procedural disenrollment rates are concerning because many
people who are disenrolled for these paperwork reasons may still be
eligible for Medicaid coverage," KFF explained earlier this week.
"Some states, such as Maine, have temporarily paused procedural
terminations for some enrollees while the states address problems in
the renewal process that lead to increased procedural disenrollments."

"Many of these individuals did not receive any notice of denial,
leaving them unaware of their coverage termination."

Texas has removed more people from Medicaid than any other state,
disenrolling around 617,000 in just a few months.

Late last month, the state's entire Democratic congressional
delegation implored
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the Centers for Medicare and Medicaid Services (CMS) to intervene and
ensure that Texas' Republican-dominated government complies with
federal rules to "prevent the catastrophic loss of coverage."

The Democratic lawmakers, led by Reps. Lloyd Doggett and Greg Casar,
cited a July whistleblower letter
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that issued dire warnings about Texas' Medicaid purge.

The whistleblowers, who identified themselves as employees of the
Texas Health and Human Services Commission, wrote that roughly two
weeks after the mass disenrollments began, "we started receiving
numerous emails from agency leadership indicating that thousands of
individuals had been erroneously denied coverage."

"As a result of the initial process we ran in April, we were informed
that approximately 80,000 individuals lost coverage erroneously,
including several thousand pregnant women who required critical
services during their pregnancies or essential post-pregnancy care
coverage," the whistleblowers wrote. "Additionally, we received
subsequent emails from agency leadership indicating that several
thousand elderly individuals were slated to lose medical coverage,
which previously paid a portion of their Medicare Part B expenses."

"Many of these individuals did not receive any notice of denial," they
added, "leaving them unaware of their coverage termination until their
social benefits were reduced to cover the premium payments."

Shortly after the whistleblower allegations emerged, CMS sent letters
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to all 50 states noting that it had "learned of additional systems and
operational issues affecting multiple states, which may be resulting
in eligible individuals being improperly disenrolled."

One problem identified by CMS could be having a disproportionate
impact on kids, the agency said in a statement
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"CMS believes that eligibility systems in a number of states are
programmed incorrectly and are conducting automatic renewals at the
family level and not the individual level, even though individuals in
a family may have different eligibility requirements to qualify for
Medicaid and [the Children's Health Insurance Program]," the agency
said. "For example, children often have higher eligibility thresholds
than their parents, making them more likely to be eligible for
Medicaid or CHIP coverage even if their parents no longer qualify."

Speaking on the condition of anonymity, one Biden administration told
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Washington Post_ that the number of children affected by the
programming issue "is likely in the millions."

CMS has also warned that long call center times in at least 16 states
could be causing people to give up on trying to renew their coverage.

While Republican-led such as Texas and Florida have moved aggressively
to gut their Medicaid rolls, drawing outrage and lawsuits
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from residents, California, New York, and other blue states have also
collectively removed hundreds of thousands of people from the program,
often for procedural reasons
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a nationwide crisis.

Adler-Bolton warned Friday that "this is going to become the
healthcare legacy of the Biden presidency" if his administration
doesn't act quickly.

"When we look at [Affordable Care Act] enrollment expansion, 13
million people added in 2014. We're going to see a contraction of a
similar amount—if not 10 million more—in the course of a calendar
year," said Adler-Bolton. "CMS has the authority to halt procedural
determinations today. We're only a few months into this and 74% are
procedural determinations. CMS should be saying pause... It's their
responsibility to do it."

Jake Johnson is a senior editor and staff writer for Common Dreams.

* Medicare
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* Joe Biden
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* health insurance
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