For more than a year, experts have warned that millions might be kicked off of Medicaid after the end of the continuous enrollment provision of the Families First Coronavirus Response Act. Their predictions came true; since April, upwards of 600,000 people in the United States have had their coverage terminated. Early data show that the vast majority of enrollees have lost their insurance not because they are ineligible for it but because of “paperwork issues,” ie. procedural disenrollments.

ALLEXA GARDNER: akg72@georgetown.edu 
    Gardner is a senior research associate at the Georgetown University McCourt School of Public Policy’s Center for Children and Families (CCF). 

Gardner told the Institute for Public Accuracy: “Across the board, we are seeing a significant share of procedural disenrollments. The best rate is in Pennsylvania, where 43 percent [of disenrollments have been procedural, rather than due to enrollees being deemed ineligible for coverage]. That’s still incredibly high. The highest rates, meanwhile, are in Indiana and West Virginia, where 89 percent have been procedural. That means enrollees are encountering red tape or have had their coverage terminated without getting an eligibility determination––which can occur for any number of reasons,” including if a renewal form was lost in the mail, if someone couldn’t get through to a call center with their questions, or had difficulty getting the proper documents together. 

In Florida, where 82 percent of disenrollments have been procedural, 205,000 people have been affected. 

“We were expecting a significant share of people to lose coverage for procedural reasons, given that approximately 15 million people were estimated to lose coverage [overall]. But especially in Arkansas and Florida, the numbers are significantly higher than we expected.” Gardner emphasized the high number of children that have been procedurally disenrolled, “even though they are likely to remain eligible,” and urged a messaging shift that communicates to parents that
“even if they are no longer eligible, they should still return their forms because their child is likely still eligible. Even in non-expansion states, where the majority of Medicaid enrollees are pregnant, postpartum, or very low-income people, children are still eligible.” 

Experts from CCF have urged states experiencing high rates of procedural disenrollments to pause the unwinding, giving them more time to “do additional outreach to emphasize the changes in Medicaid coverage and the need to return renewal forms, and to make sure that all parts of the process are working correctly,” to minimize the number of disenrollments. 

Gardner also emphasized the importance of people in the field gathering stories of enrollees who are facing barriers to completing their renewal forms. “If people hear stories that enrollees are not getting their forms in the mail, or that call center waits are hours-long, then those themes can help us identify where pain points are in the state, and help the state make necessary changes.”