More than 10 million people were disenrolled from Medicaid over the past six months, according to the latest data published by a KFF tracker. The tracker has collected data on Medicaid enrollment since the first states began redetermining eligibility in April, after the expiration of the federal requirement of continuous coverage during the Covid-19 public health emergency.
As of Nov. 1, Medicaid enrollment was confirmed for just over 18 million people, while 10 million lost enrollment. The disenrollment numbers have been rising steadily since the end of July as more states began redetermining eligibility.
According to KFF’s analysis, 71% of people lost coverage for procedural reasons — either because their eligibility was not automatically renewed by the state, or because they didn’t complete the necessary forms for Medicaid renewal. This is a small reduction from earlier this year, when 74% of disenrollments were procedural.
The percentage of procedural disenrollment to date varies quite dramatically between states, ranging from 96% of all disenrollment in New Mexico to 7% in Oregon, which only started its redetermination process on Oct. 1. In three states (Maine, Illinois, and Oregon), the procedural disenrollments made up significantly less than half of all disenrollments, though comparisons between states are limited by the different redetermination starting dates.
With large percentages of people taken off Medicaid for procedural reasons, there are high chances that a significant portion among them would actually be eligible, and were mistakenly removed. At times, for instance, parents may think their family isn’t eligible for Medicaid, though their children are.
Through the redetermination process, an estimated 4 in 10 children have lost coverage. This is an estimate because only 20 states share information on the age breakouts of Medicaid enrollments. In those states, out of 4.8 million disenrollments, 1.8 million were children. A large number of these children are in Texas, where they make up 70%, or 800,000, of the 1.2 million people who lost coverage. Among the states reporting, Massachusetts has the smallest percentage of children losing coverage, at 16%.
In September, the Biden administration addressed the issue of procedural disenrollment of children, pushing about a dozen states to pause or slow down their redeterminations to avoid denying coverage to eligible patients. As of September, the Centers for Medicare and Medicaid Services was able to reinstate coverage for half a million children.
CMS has offered several strategies to reduce the impact of the end of continuous enrollment, including assisting enrollees in submission processes and making it easier for eligible individuals who were removed from the rolls for procedural reasons to have Medicaid coverage reinstated. All states have adopted at least some of these strategies, with the exception of Florida.
This data still doesn’t capture the total effect of Medicaid redetermination since a majority of states didn’t start going through their rolls until June. States are expected to take a year to 14 months to complete Medicaid renewals.