News Release

Medicaid “Unwinding” Is Biggest Insurance Loss in U.S. History


Background: The newest update to KFF’s Medicaid enrollment tracker shows that as of September 5, at least 5,677,000 Medicaid enrollees have been disenrolled since states began the process of disenrolling people from Medicaid after a three-year pause during the Covid-19 pandemic, when people were not allowed to be kicked off the program. Across all states with available data, 74 percent of the people disenrolled had their coverage terminated for procedural reasons. 

    Adler-Bolton is a writer, artist, and the co-host of the Death Panel podcast. She is the author of Health Communism: A Surplus Manifesto

Adler-Bolton told the Institute for Public Accuracy: “This is the largest concentration of health insurance loss in American history. This is happening in red states like Texas, Utah, or Idaho, where we expect this brutal Medicaid retrenchment. But there are huge amounts of procedural disenrollments happening in California. It’s happening in Rhode Island and California and New Mexico. It’s not that Republicans are being extra quick about it or that Republican states haven’t fully funded their call systems so the call times are the problem.” (Mainstream media has reported that long call waits are a main issue in procedural disenrollments.) “There are claims that the call lines and the phones [are the problem]. Call times are a huge issue in states like Florida, where there is a huge Spanish-speaking population and not enough people [at Medicaid] who speak Spanish… But that doesn’t fully explain procedural disenrollments in states where there is no problem with the phones. We’re also seeing states implementing new software” that is malfunctioning.

“As of March 31st, 95-96 million people were on Medicaid… That’s a tremendous indictment of income equality and class inequality in the U.S. The Biden administration is saying we have a record low uninsurance rate. But they’re quoting [numbers from] March, before disenrollments began.

    “So far, 5-plus million have been disenrolled. This is a year-long process, and it’s just getting started. It’s moving slowly, and it’s more dangerous this way. This process is rolling, so the data is slow. We’re not going to have a full picture of how to compare states against each other for months and months. 

    “In 2020, the Biden campaign proposed Medicaid expansion and lowering the eligibility age for Medicare to 60. The plan was to get 15-20 million people onto coverage. But what they’re overseeing now is the undoing of the thing they promised to do during the campaign. It’s the largest simultaneous disenrollment in American history. When we look at [Affordable Care Act] enrollment expansion, 13 million people added in 2014. We’re going to see a contraction of a similar amount––if not 10 million more––in the course of a calendar year. 

    “This is going to become the health care legacy of the Biden presidency. This doesn’t reflect what Biden is projecting as his vision of healthcare in America.

    “CMS has the authority to halt procedural determinations today. We’re only a few months into this and 74 percent are procedural determinations. CMS should be saying pause… It’s their responsibility to do it.”