Hundreds of 1199SEIU health workers organized a rally and sat on Third Avenue, where some were arrested. They protested health care cuts in Governor Kathy Hochuls’ Medicare budget.
Lev Radin | Light Rocket | Getty’s paintings
U.S. states will start kicking as many as 15 million people off Medicaid coverage on Saturday as the emergency safety net introduced during the Covid-19 pandemic gradually ends.
Medicaid is a public health insurance program for people with lower incomes. It is managed jointly by the state and federal governments.
Congress essentially banned states from terminating Medicaid coverage during the pandemic through the Families First Coronavirus Response Act. A law passed in March 2020 provided people with a safety net as the first deadly wave of Covid swept through the nation and lockdowns crippled the US economy.
Medicaid coverage increased to over 85 million people in December, a 25% increase from February 2020, before the requirements for enrolling people in the program went into effect, according to data from the Department of Health and Human Services.
But states could start kicking people off Medicaid on Saturday if they no longer meet the program’s pre-pandemic eligibility requirements, which are mostly based on income. Congress in December repealed a provision in the federal spending rules that allows states to start deregistering people on April 1.
While some states will start ending coverage in April, others wait until May, June, July and October before doing so. Below is a list of when all 50 states will begin to end coverage.
Click here for a list of when states will have completed their first round of Medicaid coverage. The table was provided by the Kaiser Family Foundation.
States have up to one year to determine if a person is still eligible for Medicaid and 14 months to complete the renewal or opt-out process, in accordance with HHS guidelines.
HHS estimated at 15 million people may lose coverage when the program reverts to pre-pandemic eligibility requirements. Many of these people are waiting qualify for other forms of health insurance.
According to the HHS, the changes will disproportionately affect people of color and young people. About 30% of people likely to lose Medicaid coverage are Hispanic, and 15% are Black. At the same time, more than 5 million children and 4.7 million adults aged 18 to 34 be kicked out of Medicaid, according to the HHS.
An estimated 2.7 million people could lose their Medicaid coverage should be eligible for tax credits under Obamacare health insurance markets. About 62% of these people are expected to qualify for no-contribution plans. Another 5 million people are expected to be able to obtain other forms of insurance, mostly through their employer.
HHS has established a special enrollment period at health care.gov to help people transition to Obamacare market coverage if they lose their Medicaid between March 31, 2023 and July 31, 2024.
Most states, 33 in all, use health care.gov as their insurance market. The 17 states that manage their own trading platforms may offer this special registration period, but are not required to do so.
As many as 6.8 million people could lose Medicaid even though they still do is eligible for the program. Before the pandemic, people were often out of reach due to bureaucracy. A person may lose coverage if they do not complete the annual renewal process or if their state is unable to contact them due to a change of address or other issues.
Under Under a congressional order passed in December, states are required to make good-faith efforts to contact persons whose eligibility is being reviewed through more than one method of communication. In other words, the state cannot terminate someone’s insurance simply because an email was returned as undeliverable, which is often the case due to a change of address or other reasons.
HHS estimated in August 2022 that about 383,000 people who lose Medicaid as the pandemic dies down will fall into a bureaucratic gap called the “coverage gap.”
This gap exists in the 10 states that have not extended Medicaid to people whose income is up to 138% above the federal poverty level. As a result, some people in these states who are struggling to make ends meet are still not eligible for Medicaid because the income requirements are so low. Some of these people also do not qualify for Obamacare tax credits, leaving them with no affordable health insurance options.
Texas and Florida are the two most populous states that still haven’t expanded Medicaid.