• Posted July 31, 2023

Paperwork Causing Many Americans to Lose Medicaid Coverage, White House Warns

Large numbers of Americans who were dropped from Medicaid this spring lost their coverage because of paperwork problems, and not because they weren't still eligible for the public health insurance program.

"I am deeply concerned about high rates of procedural terminations due to 'red tape' and other paperwork issues,"Health and Human Services Secretary Xavier Becerra wrote in a letter sent Friday to all governors, the Associated Press reported.

The changes are happening now because a prohibition on removing Medicaid coverage during the pandemic has now been lifted. States have now begun doing annual eligibility redeterminations.

Among 18 states that began this review in April, about 1 million people continued to receive their health coverage, the AP reported. Another 715,000 lost that coverage, but in 4 of 5 cases that was for procedural reasons, according to data from the federal U.S. Centers for Medicare and Medicaid Services.

Becerra encouraged governors to make efforts to keep people on Medicaid, including by using electronic information from federal programs, such as food stamps, to confirm eligibility.

Nearly 93 million people had Medicaid coverage in February 2023, a much higher number due to the lack of redeterminations than the 71 million who were covered in February 2020, the AP reported.

The dropped eligibility data is limited to the first month of state Medicaid reviews from quick-acting states. Others may have also dropped people from coverage since then, the AP reported.

Many may be "caught in a bureaucratic nightmare of confusing forms, notices sent to wrong addresses and other errors," said Michelle Levander, founding director of the Center for Health Journalism at the University of Southern California.

Data suggests that some states did a better job of answering questions about Medicaid coverage, the AP reported. The average call center wait time was a minute or less in April in 19 states and Washington, D.C. Conversely, it was 51 minutes in Idaho, 44 minutes in Missouri and 40 minutes in Florida.

The AP and health care advocacy group gathered data showing that about 3.7 million people already have lost Medicaid coverage, including about 500,000 in Texas, 400,000 in Florida and 225,000 in California.

In California, 89% of those cuts were for procedural reasons. That was true also for 81% in Texas and 59% in Florida, according to the AP.

Some states are voluntarily slowing cuts while working with CMS. South Carolina extended its eligibility renewal deadline from 60 days to 90 days.

Michigan renewed more than 103,000 Medicaid recipients in June, while removing 12,000. Yet, more than 100,000 people have incomplete June eligibility cases.

Even though people who were incorrectly dropped can regain their coverage if they prove eligibility within 90 days, there are still issues, according to advocates.

"State government is not necessarily nimble," Keesa Smith, executive director of Arkansas Advocates for Children and Families, told the AP. "When individuals are being dis-enrolled, the biggest concern ... is that there is not a fast track to get those individuals back on the rolls."

Meanwhile the insurance companies that run the Medicaid programs for the states are working to ensure people still have some health coverage. Officials from Molina Healthcare, a multi-state insurer, said the company is working to enroll those dropped from Medicaid in individual insurance plans sold through state-based marketplaces, the AP reported.

More information

The U.S. Department of Health and Human Services has more on Medicaid eligibility.

SOURCE: Associated Press