Feb 6, 2024 - Health

Medicaid enrollment cuts led to more evictions, study finds

Illustration of a stethoscope tube making the shape of a house.

Illustration: Gabriella Turrisi/Axios

A major purge of Tennessee's Medicaid rolls almost 20 years ago led to a big increase in evictions, according to a new Health Affairs study that may hold lessons for the ongoing "unwinding" of pandemic-era coverage protections.

Why it matters: More than 16.4 million Americans have been disenrolled from Medicaid since April, when the end of the COVID-19 emergency meant states were no longer barred from terminating coverage.

  • A significant portion of those losing Medicaid could be at higher risk of losing housing, the study suggests.
  • Eviction and loss of Medicaid are also both linked to worse health outcomes as they make it harder to access and afford care.

What they found: When Tennessee cut off Medicaid coverage for 190,000 people in 2005 to slash growing costs, the state saw a 24.5% greater increase in the average annual number of evictions compared with other Southern states, researchers found.

  • The average number of eviction filings increased 27.6% relative to Tennessee's neighboring states.
  • The researchers analyzed eviction data from Southern states between 2000 and 2009.

Between the lines: It's challenging to extrapolate what Tennessee's example may mean for the current Medicaid unwinding process, the researchers wrote.

  • With housing affordability at a record low and health care costs continuing to rise, suddenly having to spend more on care after losing Medicaid could make it even harder for someone to pay rent today compared with 20 years ago.
  • Many of the eviction protections put in place during the pandemic expired before states were allowed to pare their Medicaid rolls.
  • One mitigating factor could be the heavily subsidized Affordable Care insurance marketplaces, which weren't available in 2005 when Tennessee made the major Medicaid cuts.
  • A portion of people who recently lost Medicaid coverage have likely wound up in the ACA marketplaces, contributing to record enrollment this year.
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