19 million in the US purged from Medicaid rolls in “post-pandemic” unwinding of expanded coverage

More than 19 million people in the US have been disenrolled from Medicaid in the year since the Biden administration began “unwinding” the expansion of the program that was initiated at the outset of the COVID-19 pandemic.

According to an analysis by the Kaiser Family Foundation (KFF) published last Tuesday, “At least 19,156,000 Medicaid enrollees have been disenrolled as of March 26, based on the most current data from all 50 states and the District of Columbia.”

Henry Ford Hospital in Detroit

The KFF Medicaid Enrollment and Unwinding Tracker shows that 20 percent of the 94 million people who were enrolled in Medicaid as of March 2023 have been kicked off the program. The report adds, “children accounted for almost four in ten (37 percent) Medicaid disenrollments in the 21 states reporting age breakouts.” There have been 3,396,000 children kicked off Medicaid since April 1, 2023.

As part of the official federal national health emergency that was declared in March 2020, the rules for access to public aid were expanded, including eligibility for Medicaid health insurance. The pandemic emergency rules also had a provision for continuous enrollment which means that, once someone qualified for Medicaid, they could not be removed due to changes in circumstances that would previously have made them ineligible.

The KFF report says that 70 percent of those kicked off Medicaid were removed for procedural reasons. This means that people have been disenrolled, “because they did not complete the renewal process [this] can occur when the state has outdated contact information or because the enrollee does not understand or otherwise does not complete renewal packets within a specific timeframe.”

In other words, there is a high likelihood that many of those being purged from coverage are still eligible. As the KFF report says, “High procedural disenrollment rates are concerning because many people who are disenrolled for these paperwork reasons may still be eligible for Medicaid coverage.”

Medicaid is the largest US government health insurance program and provides health insurance for adults and children with limited income and resources. Medicare covers nearly 66 million people who are 65 or older or younger people with disabilities.

While the federal government provides most of the funding and sets the baseline standards for Medicaid, the states also fund the program and have wide latitude in determining who is eligible and what benefits they qualify for.

For this reason, the disenrollment of Medicaid recipients has taken place at uneven rates and the unwinding has impacted people and families differently depending on which state they live in. For example, 2.1 million people or 52 percent of those who completed the renewal process in Texas were disenrolled. In Oregon, of the 208,600 people disenrolled from Medicaid, 80 percent or 166,880 are children.

While some Republican Party-controlled states, such as Texas, have moved more rapidly to carry out the purge from Medicaid, Democratic Party-controlled states have implemented the unwinding steadily over the past 12 months. In Utah, where the Republican Party has controlled the state government since 1992, the disenrollment rate is 57 percent, the highest in the country, and 92 percent of those removed have been on procedural grounds.

In New York state, where the Democrats are in control of the governorship and both houses of the state legislature, the fourth largest number of people have been kicked off Medicaid at 1.1 million, or approximately one-third of those who have reapplied.

The Detroit News reported that 701,589 people in the state of Michigan have lost Medicaid health coverage since June 2023. The News report went on to say that this purge is more than three times the estimate made by the Michigan House Fiscal Agency last year.

In Michigan, single adults are not permitted to earn more than $18,000 per year—the equivalent of a full-time job that pays about $9 per hour—under the rules for Medicaid eligibility. Pressure has been applied by the corporate and financial elite demanding that people be driven off the Medicaid rolls. The News report says that the Mackinac Center for Public Policy, the largest US-state based business think tank, has said “reinforcing the eligibility rules is a welcome development.”

The most striking example of the devastating impact of terminating Medicaid coverage for those 19 to 64 years old is the fact that the pandemic continues and cases and deaths in Michigan are up in recent days. According to the latest data maintained by the Michigan Department of Health and Human Services, there were 1,785 cases, 307 hospitalizations and 34 deaths in the week ending March 26. These numbers are a vast undercount since many people do not test for the virus or seek medical care when they have symptoms.

As reported previously on the WSWS, the impact on community health centers and health facilities in rural areas due to revenue losses that will bring closures and layoffs will make it impossible for sections of the working class to have access to health care. Billions of dollars in medical services revenue will be cut off from these providers due to the purging of people from Medicaid.

The disenrollment of millions of children from Medicaid is a stark example of the vicious bipartisan social policy of the Democrats and Republicans. For the capitalist political establishment from Washington D.C. to every state house in the country, there are no funds available to ensure that children have access to basic healthcare coverage while there are limitless billions to be spent on the military and to fund and arm the US-NATO war against Russia in Ukraine and for the genocidal ethnic cleansing of Palestinians from Gaza by the Israeli government.