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States to reinstate half a million people’s Medicaid coverage after system errors

Across the country, thousands of people have been mistakenly dropped off Medicaid and CHIP since the Spring. System glitches are behind this undue massive loss of coverage.

Thirty states reported that they have mistakenly dropped tens of thousands of people, including children, from Medicaid and the Children’s Health Insurance Program, CHIP.

In the Midwest and the surrounding region, Illinois, Iowa, Kansas, Kentucky, Minnesota, Ohio and Nebraska reported that they have not been complying with federal rules to renew people’s coverage after pandemic-era federal policies, which protected people’s public health insurance coverage, expired last Spring.

Federal officials had sounded the alarm over a system states use to draw on information from reliable data sources like state wage data to determine if a person is eligible for Medicaid. This process is called “ex-parte” or auto-renewal –– a convenient way for states to renew people’s coverage without requiring them to take any steps.

As part of this process, federal rules require state agencies to redetermine the eligibility of every person in the household individually, regardless of whether other household members qualify or not. But some states have been assessing eligibility for households as a whole and in the process disenrolling eligible individuals who may still qualify, like children who have higher household income thresholds.

The impact of this varies from one state to another.

State officials in Kansas and Ohio reported that between 10,000 and 49,999 people were mistakenly disenrolled, while Illinois and Kentucky officials reported that less than 10,000 people were impacted. Iowa, Minnesota and Nebraska state officials reported that they are still assessing the number of people impacted.

Federal officials have ordered states to fix their process as soon as possible. They said that nearly half a million people across the country should have their coverage reinstated soon.

This state-reported information comes after the federal government had sent letters to all states and the District of Columbia late August flagging some concerning systemic problems, asking states to assess their processes and start taking corrective action as soon as possible.

Other issues that were raised in those letters were long call center wait times and abandoned calls, and people losing their coverage due to paperwork issues –– like missing or delayed mail –– rather than a confirmation of ineligibility.

Since the end of the federal pandemic public health emergency last Spring, states have been sifting through their Medicaid rolls to determine who still qualifies for the government health insurance. So far, more than 7.4 million people have been dropped off Medicaid according to the health policy nonprofit KFF, and 74% of them have lost their coverage for procedural or paperwork errors, not because the state has proof that they are ineligible.

You can reach Farah Yousry at fyousry@wfyi.org. Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations across the Midwest and surrounding areas — including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky.

Copyright 2023 Side Effects Public Media. To see more, visit Side Effects Public Media.
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Side Effects Public Media

Side Effects is a health news service exploring the impacts of place, policy and economics on Americans' health.

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