May 25, 2023 - Health

Medicaid unwinding will catch many off-guard, survey shows

First anticipated Medicaid terminations, by state
Data: Center for Medicare and Medicaid Services; Chart: Tory Lysik/Axios Visuals

About 1 in 4 Medicaid enrollees don't know where to look for other coverage if they drop off the safety net program's rolls, and 15% say they'll be uninsured, according to a new KFF survey.

Why it matters: The findings begin to quantify how unprepared many enrollees are for the eligibility renewal process that's begun in states with the end of the COVID-19 public health emergency.

  • 65% of recipients say they didn't have a change in income or other change that would make them ineligible for the program, underscoring the importance of navigating the renewal process and not getting lost in bureaucratic churn.

What they found: KFF surveyed more than 3,600 insured adults in February and March, including more than 1,200 adults with Medicaid coverage. 65% of those on Medicaid were not aware that states could start kicking people off the rolls this year.

  • About half of adults enrolled in Medicaid have never participated in a renewal process before.
  • One-third of enrollees had not provided contact information to their state Medicaid agency in the last year, which means they might be culled because of the inability to reach them.
  • If their Medicaid coverage is terminated, 27% wouldn't know where to look for other health coverage, and 15% say they would just be uninsured. Only a third of adults surveyed said they would look for coverage on the Affordable Care Act marketplaces.

Zoom out: More than 192,000 people have been kicked off Medicaid in five states where redeterminations have started.

  • Some may have found workplace coverage or will be able for ACA subsidies.
  • One NORC analysis, funded by AHIP, found that from 48% to 57% of a state's Medicaid enrollees will transition to an employer's health plan.
  • NORC also estimates that 3.8 million people will become uninsured at the end of the redetermination process.
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