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What will happen to unprecedented high Medicaid enrollment after the public health emergency? https://www.rwjf.org/en/library/research/2021/09/what-will-happen-to-unprecedented-high-medicaid-enrollment-after-the-public-health-emergency.html. Published Sept. 15, 2021. Accessed Sept. 16, 2021.

Disclosures: Buettgens reports no relevant financial disclosures.
September 21, 2021
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15 million people may lose Medicaid coverage when public health emergency ends

Source:

What will happen to unprecedented high Medicaid enrollment after the public health emergency? https://www.rwjf.org/en/library/research/2021/09/what-will-happen-to-unprecedented-high-medicaid-enrollment-after-the-public-health-emergency.html. Published Sept. 15, 2021. Accessed Sept. 16, 2021.

Disclosures: Buettgens reports no relevant financial disclosures.
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A new report showed that about 15 million Americans who enrolled in Medicaid during the public health emergency could lose coverage when the emergency declaration ends.

Those at risk for losing coverage include almost 9 million adults and 6 million children, according to the analysis published by the Urban Institute with support from the Robert Wood Johnson Foundation.

Graphical depiction of data presented in article

“There is good evidence that Medicaid coverage saves lives and increases families’ financial stability. Becoming uninsured would adversely affect both,” Matthew Buettgens, PhD, a senior fellow in the Health Policy Center at the Urban Institute, told Healio Primary Care. “Many of those losing Medicaid would be eligible for other types of health coverage, and states can substantially reduce the number becoming uninsured by providing effective outreach and assistance.”

Matthew Buettgens

Buettgens and coauthor Andrew Green, MSDSPP, a research analyst in the Health Policy Center at the Urban Institute, analyzed state enrollment patterns from February 2020 to January 2021 using Medicaid enrollment data from CMS and individual state Medicaid websites for all available months in 2020 and 2021. They projected possible disenrollment scenarios for 2022.

By the end of the second quarter of 2020, about 62.5 million nonelderly people were enrolled in Medicaid. Following this period, enrollment increased by about 1% each month. Buettgens and Green said they expect this trend to continue while the emergency declaration is still in place. By the second quarter of 2021, they approximated that 72 million nonelderly people were enrolled.

Moreover, Buettgens and Green estimated that 17 million more nonelderly people will be enrolled in Medicaid at the end of 2021 compared with enrollment prior to the pandemic. Overall, an estimated 76.3 million individuals aged younger than 65 years would be enrolled, according to Buettgens and Green.

In a scenario where the emergency declaration is lifted at the end of 2021, the researchers predicted that 15 million people would lose coverage in 2022, while one-third of adults would potentially qualify for subsidized private health coverage in the Healthcare Marketplace. The remaining individuals without coverage would likely have access to employer coverage through their family or be eligible for other sources of subsidized coverage, the authors wrote. If the American Rescue Plan Act is made permanent, one-third of adults losing coverage would be eligible for Marketplace premium tax credits.

Among the children losing coverage, only 57% would be eligible for the Children’s Health Insurance Program, and 9% would be eligible for Marketplace coverage with tax credits, according to the authors. These alternatives to Medicaid will likely cost families much more, Buettgens and Green wrote. They projected that 7 million people will become disenrolled in the first half of 2022.

However, the tax credits would make private health coverage more affordable, according to Buettgens.

“If a patient has lost Medicaid, a physician could suggest that they check with HealthCare.gov or their state Marketplace to see if they qualify,” he said.