As individual states continue to disenroll millions of people from Medicaid and the Children’s Health Insurance Program (CHIP) now that pandemic-era suspension of participation guidelines has come to an end, new data from the U.S. Department of Health and Human Services shows that more than 50% of the children who have lost health coverage this year come from just five states.
From March 2023, when the disenrollment process began, to the end of September, 2.2 million children were removed from Medicaid and CHIP, two programs that overlap and are typically lumped together. The five states with the largest total declines in enrollment – Texas, Florida, Georgia, Ohio and Arkansas – accounted for 54% of the reductions, or more than 1.2 million children.
All five states are led by Republicans, and the first three have refused to expand their Medicaid systems as allowed by the Affordable Care Act. In terms of total disenrollment, the 10 states that have refused Medicaid expansion – Texas, Florida, Georgia, Mississippi, Alabama, South Carolina, Tennessee, Kansas, Wisconsin and Wyoming – have removed more children from coverage than all of the expansion states combined, HHS said.
Echoing the worries of many healthcare experts, the Biden administration has expressed concerns that some states have been too aggressive in removing beneficiaries from their Medicaid and CHIP rolls, with many people losing coverage simply because they failed to complete various kinds of paperwork. HHS said Monday that Secretary Xavier Becerra has sent letters to the nine states with the highest disenrollment rates urging them to “adopt additional federal strategies and flexibilities to help prevent children and their families from losing coverage due to red tape.”
Among other things, Becerra called on governors to remove barriers to participation such as CHIP enrollment fees and premiums; to make it easier to automatically renew children for coverage; to expand efforts to contact families facing renewal; and to expand their Medicaid programs so that children do not fall into a coverage gap. “I urge you to ensure that no eligible child in your state loses their health insurance due to ‘red tape’ or other bureaucratic barriers during the Medicaid enrollment process,” he wrote.
