Two million US children have been removed from Medicaid health insurance since April

New research shows that at least two million US children who are eligible for government assistance have been kicked off of Medicaid health insurance since last April, when federal pandemic aid programs were halted.

According to data compiled by the Georgetown Center for Children and Families and KFF (Kaiser Family Foundation), under the title “Medicaid Enrollment and Unwinding Tracker,” as of November 8 the two million children who qualified for ongoing coverage had their insurance terminated largely due to bureaucratic bungling, including missing paperwork and government errors.

Additionally, the Georgetown and KFF study says that due to lags in data reporting by states, the numbers being reported “undercount the actual number of disenrollments to date.”

Last Thursday, Joan Alker, the executive director of the Georgetown center and a research professor at the university’s McCourt School of Public Policy, told the New York Times it is likely that at least one million of these children are currently uninsured.

Alker added that the numbers of children being disenrolled nationally is accelerating, and, in the coming weeks, new data from the states “will probably show that three million children have lost coverage.” She went on to call the situation “unprecedented” and warned that the mass disenrollment of children from Medicaid “has the potential to increase the uninsured rate for children by the largest amount that we’ve seen in decades.”

This May 17, 2021 image shows Margarita Mora preparing to drop off her daughter at Cuidando Los Ninos in Albuquerque, New Mexico. The charity provides housing, child care and financial counseling for mothers, with expanded Child Tax Credit payments that have since ended. [AP Photo/Susan Montoya Bryan]

According to the research tracker website, it provides “the most recent data on monthly Medicaid disenrollments, renewals, overall enrollment and other key indicators reported by states during the unwinding of the Medicaid continuous enrollment provision.” The tracker gathers available data about the unwinding of Medicaid coverage from state websites and the Centers for Medicare & Medicaid Services (CMS) of the US Department of Health and Human Services (HHS).

The data shows that, overall, 10.135 million people have been disenrolled from Medicaid nationwide, even though they completed renewal applications, due to the unwinding that began in April. Another 18 million have had their coverage renewed. The study shows that there is a “wide variation in disenrollment rates across reporting states.” In Texas, for example, 1.2 million, or 65 percent, of nearly two million people statewide have been disenrolled.

The report says that states with high disenrollment numbers “are initially targeting people early in the unwinding period that they think are no longer eligible or who did not respond to renewal requests during the pandemic …”

These vicious policies have been permitted by the Biden administration, even though it has the authority to halt the unwinding process.

The impact to low-income families of having children with no health insurance is devastating. If there is no one in the family who can cover a child on his or her private health insurance plan, or the family cannot afford insurance through the misnamed Affordable Care Act (also known as Obamacare), it faces the alternative of foregoing treatment or being bankrupted by medical expenses.

The New York Times reported, for example, that a family living in the Orlando, Florida area lost Medicaid insurance twice due to “enrollment errors,” and the 13-year-old son was unable to function in school without special medication that cost more than $1,000 per month.

The lack of health insurance among children is especially harsh in the fall and winter, when respiratory illnesses circulate widely.

Daniel Tsai, a senior official at the Centers for Medicare and Medicaid Services, told the Times: “I go to sleep at night thinking about this. We should not have kids being uninsured without health care, with families worried about how to pay for medication or what to do if your kid needs to go to the emergency department.”

It is estimated that during the pandemic over 90 million people, more than 25 percent of the US population, were enrolled in the Medicaid program. When the pandemic-related program ended in April, the federal government claimed that a majority of the children who no longer qualified for Medicaid would be re-enrolled in the state-run and partially state-funded Children’s Health Insurance Program (CHIP). 

CHIP is supposed to be made available to children in families with incomes that are too high for Medicaid eligibility. According to researchers, however, the 21 states with CHIP programs had only added 87,355 children to the program after 1.5 million were disenrolled from Medicaid.

The devastating impact of ending pandemic-related federal Medicaid protections was well known before the program ended in April. Studies were published more than a year ago predicting that millions would be kicked off the federal health insurance program and wind up with no coverage at all.

An extensive brief was published by the assistant secretary for planning and evaluation at the Office of Health Policy of HHS in August 2022, warning that the unwinding of Medicaid coverage for millions would result in mass coverage loss. The report projected that 15 million people would leave the program, with 8.2 million losing eligibility and 6.8 million losing coverage “despite still being eligible.”

In particular, the HHS projection said, “Children and young adults will be impacted disproportionately, with 5.3 million children and 4.7 million adults ages 18-34 predicted to lose Medicaid/CHIP coverage. Nearly one-third of those predicted to lose coverage are Latino (4.6 million) and 15 percent (2.2 million) are Black.”

Another report from Georgetown University McCourt School of Public Policy Center for Children and Families warned that the rate of uninsured children in the US would rise rapidly during the “unwinding” of the pandemic Medicaid coverage mandate. In a paper published on February 1, 2023, the Georgetown center wrote:

We have estimated that as many as 6.7 million children are at risk of losing coverage during the unwinding. The vast majority of children (73.6%) losing coverage will remain eligible for Medicaid but are likely to lose coverage due to bureaucratic snafus.

This is precisely what is now happening since absolutely nothing was done by the Biden administration, or the Democrats and Republicans in Congress, to prevent such a disaster from unfolding. The priorities of the capitalist political establishment, as throughout the COVID-19 pandemic, have remained centered on ensuring corporate profits and waging war, to the detriment of public health and the preservation of life.

As the World Socialist Web Site reported previously, child poverty in the US more than doubled last year, increasing from 5.1 percent of children in 2021 to 12.4 percent in 2022, while overall poverty rose from 4.6 to 12.4 percent during the same period. The alarming rise in poverty is directly connected to terminating the expansion of the Child Tax Credit (CTC) and the Supplemental Nutritional Assistance Program (SNAP).

These measures were put in place as part of limited COVID mitigation policies implemented at the outset of the pandemic. The Biden administration brought all of these initiatives to an end as part of the campaign to declare the pandemic over, even though new variants of the coronavirus continue to infect and kill people across the country.