Sep 13, 2023 - News

Iowa's Medicaid disenrollment has domino effect

Illustration of dominos falling forward, with the last domino showing an exclamation point

Illustration: Annelise Capossela/Axios

Iowa's disenrollment of about 120K residents from Medicaid since April is factoring into record requests for humanitarian help, a metro health organization and multiple food assistance networks tell Axios.

Why it matters: The domino effect comes as federal officials warn state Medicaid directors that some recipients who were terminated from the program shouldn't have been.

Catch up fast: A pandemic-related safeguard that generally required states to provide continuous Medicaid coverage ended March 31.

  • Nearly six million Americans have lost their health coverage as of last week, according to data published by KFF.
  • High percentages of those who have lost coverage — including about 96K Iowans — are for procedural reasons like not returning their redetermination paperwork in time, Iowa Public Radio (IPR) reports.

What's happening: Requests for free or reduced medical assistance is "unlike anything I've seen in the 35 years I've been working here," Kelly Huntsman, CEO of Primary Health Care, tells Axios.

  • The group, which last year provided assistance to about 40,000 people in Polk, Marshall and Story counties, anticipates the need will continue to grow.
  • It may have to scale back some services as a result, she says.

Meanwhile, the Food Bank of Iowa and the Des Moines Area Religious Council food pantry networks have both set "staggering records" in recent months.

  • Neither group tracks Medicaid enrollment of their recipients but any financial setback can cause someone to make "impossible choices" between food and medicine that can result in them seeking pantry assistance, food bank spokesperson Annette Hacker tells Axios.

The big picture: At least a dozen states have been instructed by federal officials to pause procedural terminations and reinstate coverage as they fix their systems, Axios' Peter Sullivan reports.

  • The Iowa Department of Health and Human Services did not respond to our inquiry about its current disenrollment status.

Of note: Iowa officials estimate about 18% of its Medicaid recipients, or about 150,000 people, will be disenrolled, per IPR.

  • Some people can transition to plans under the Affordable Care Act, but two-thirds of disenrolled recipients have traditionally experienced a period with no insurance, per KFF.

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