May 9, 2024 - News

Medicaid removals exceed projections

Illustration of a red cross made from childrens' blocks toppling over.

Illustration: Maura Losch/Axios

Texas removed far more children from its Medicaid rolls last year than observers expected, per a new report. State officials say the numbers are in line with their projections.

Why it matters: Even brief gaps in insurance can disrupt care and worsen health outcomes — especially for children, per an Urban Institute analysis.

  • In Texas, many children and adults lost coverage for procedural reasons like missed paperwork — not necessarily because they were ineligible.

Catch up quick: States paused regular Medicaid eligibility checks during the pandemic, allowing people to keep coverage. They began rechecking in April 2023.

  • That led to a cascade of problems stemming from overwhelmed technology, outdated information about Medicaid recipients, and a lack of resources for state employees.

State of play: Texas has removed more than 2 million people from its Medicaid program since last April, per the most recent state data.

Zoom in: As of November, eight states — including Texas — disenrolled more than 100% of the Urban Institute's projected numbers over the last year.

  • Texas' net overall disenrollment exceeded 117% of the think tank's projections — and exceeded projections by 178% for disenrollment of children alone.

Threat level: "This suggests that many eligible people may be among those losing Medicaid and raises the possibility that this problem may increase," Matthew Buettgens, senior fellow at the Urban Institute, said in a statement.

The other side: "Our Medicaid enrollment is in line with our ... projections and what we anticipated our disenrollments to be at this time," Texas Health and Human Services Commission spokesperson Tiffany Young tells Axios.

What's next: Texas has until the end of the month to finish eligibility checks, Young says.

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