Without Action, Millions Will Lose Medicaid


Affordable and protected healthcare must the pillar of public health. (Courtesy of Twitter)

State officials haven’t double-checked Medicaid enrollee’s eligibility in over three years. Evaluations were halted as part of an emergency pandemic measure, but that policy is about to end. Millions of Americans are now at risk of losing their health benefits because the states aren’t doing anything to assist those who will lose coverage. In fact, many states have decided to take the opposite action.

While Congress has given states a year to complete re-evaluations, many officials are purposefully speeding up the process. The opportunity for government to decrease spending on healthcare is a financial incentive for states to tear down the pandemic measure as fast as possible. Those who no longer qualify for Medicaid will have lost that coverage by the end of the year, and rushing the process increases the possibility of mistakes.

According to some projections, most people who end up losing benefits could still be eligible for Medicaid but slip through the system’s cracks due to careless procedures. Relocating to a new home or missing the email notices are two simple ways officials could fail to confirm an enrollee’s eligibility. There are over 90 million people currently on Medicaid who must be re-checked, and many state offices are too understaffed to carry out the process thoroughly. So, if people are skipped over and still qualify, they will lose coverage — even when it isn’t their mistake. 

The pandemic measure was an emergency policy; it wasn’t designed to last forever, and holding re-evaluations at some point were always part of the plan. That being said, many states’ ways of carrying out the policy change will negatively impact Americans. For example, in Florida, officials have failed to provide any mechanisms for directing people to other coverage options. Some states have opted out of policies that would make automatic checks possible. These policies, known as ex parte renewals, would use existing data to verify people’s Medicaid qualifications without having to contact the enrollee directly. By rejecting these measures, these states increase their chances of letting more eligible people fall through the cracks. 

People who fail to qualify for Medicaid upon re-evaluation also face the risk of not finding any other viable insurance options. Florida isn’t alone in its failure to provide Americans with other coverage options. Individuals in states that have decided to refuse expanding the Medicaid program under the Affordable Care Act, including Georgia, Kansas and Wyoming, could find themselves out of luck. Known as the coverage gap, people will be forced into the unfortunate position of being ineligible for Medicaid or subsidies to buy marketplace insurance, yet lacking the adequate income to purchase it themselves.  

Healthcare prices in the United States are much higher than in other developed nations, which makes it difficult to afford private options. The reasons for the increased expenses range from the consolidation of hospitals to inefficiencies that come from the complexities of the healthcare system. The OECD’s 2022 Health Statistics found that the United States spends $1,000 per person on administrative costs alone, which is five times more than the average of other wealthy nations. This means that the higher price doesn’t correlate with higher quality care: the U.S. performs worse in common health metrics like infant mortality, life expectancy and unmanaged diabetes in comparison with most other wealthy countries. 

Proponents of removing people from Medicaid want to reduce the amount of state funding dedicated to expensive coverage. But the public healthcare program works differently than marketplace insurance options. The administrative costs of Medicaid are significantly lower than private providers. In fact, studies show that Medicaid expansion generally generates enough savings to offset a state’s share of the cost — even without imposing additional taxes. So, if states’ rationale for speeding up re-evaluations is to lessen the burden on state funds, rapidly shrinking public health coverage isn’t going to help them achieve that outcome. 

Still, so long as private insurance options dominate the healthcare market, Medicaid enrollees must meet qualifications in order to receive those benefits — and those qualifications have to be structured and confirmed periodically. But that doesn’t mean states should do everything in their power to lessen the number of people who meet those requirements. 

The whole point of affordable, state-funded healthcare is to help provide all individuals with the health and security services they need to stay alive. Rushing through re-evaluations minimizes the importance of the lives we are meant to be prioritizing. On top of that, states that aren’t establishing programs to help individuals purchase alternative coverage options contribute to that disregard. 

Lindsey Osit, FCRH ’24, is a journalism Major from South Windsor, Conn.