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Rise in Medicaid Disenrollment Caused by Administrative Difficulties

The Biden administration has released figures confirming that many people who had health coverage under Medicaid during the pandemic are now losing it. While a decline in Medicaid coverage was expected, health officials are concerned about the large numbers of people being dropped from the rolls due to administrative difficulties.

In April, 18 states began reviewing their Medicaid rolls post-pandemic. Out of the recipients, coverage was continued for approximately 1 million individuals, but 715,000 were terminated. Of those dropped, 4 out of 5 were for procedural reasons, according to data from the federal Centers for Medicare and Medicaid Services.

Health and Human Services Secretary Xavier Becerra has reached out to all governors, urging them to make efforts to retain people on Medicaid. One suggestion is to use electronic information from other federal programs, like food stamps, to automatically confirm eligibility for Medicaid, eliminating the need for mailing and returning documents.

During the pandemic, states were prohibited from ending Medicaid coverage, resulting in a significant increase in enrollment. However, with the prohibition lifted in April, states have resumed annual eligibility redeterminations. The most recent federal data only captures the first month of state Medicaid reviews, but information from other sources suggests that about 3.7 million people have already lost Medicaid coverage.

Many who have lost coverage may still be eligible but have encountered difficulties with forms, notices sent to the wrong addresses, and other administrative errors. While some states have worked to improve procedures for determining eligibility and have paused Medicaid removals, others have reported high percentages of procedural terminations.

People who are dropped from Medicaid have the opportunity to regain coverage retroactively if they provide eligibility proof within 90 days. However, advocacy groups point out the challenges in getting individuals back on the rolls swiftly.

Insurance companies running Medicaid programs are also working to reduce procedural terminations and enroll people in new plans. Some insurers have reported losing a significant number of Medicaid customers due to eligibility redeterminations but anticipate that many of them will reenroll in the future.

While the federal data only covers April, it indicates that the average Medicaid call center wait times vary greatly between states, with some states experiencing much longer wait times than others.

In conclusion, administrative difficulties are leading to a rise in Medicaid disenrollment, with many individuals losing coverage due to procedural reasons. Efforts are being made to improve eligibility determination processes and reduce terminations, but challenges remain in swiftly reinstating individuals on Medicaid.

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