States with the Largest Medicaid Enrollment Declines
Medicaid enrollment has seen a significant decline since the redetermination process began in April 2023, following the COVID-19 public health emergency (PHE). The process, completed in most states, has resulted in a 14.3% drop in enrollment, according to the Kaiser Family Foundation (KFF). Although many states have finished the process, a few are still undergoing Medicaid redeterminations.
Understanding Medicaid Redetermination
Medicaid redetermination is the process of reviewing the eligibility of Medicaid beneficiaries to ensure they still meet the requirements of the program. During the COVID-19 PHE, the federal government placed a moratorium on disenrollment, meaning states were prohibited from removing individuals from the Medicaid rolls, regardless of their eligibility status. This resulted in unprecedented enrollment numbers, with millions of Americans benefiting from continuous coverage.
However, when the PHE ended in early 2023, states resumed redeterminations in April. As a result, millions of people have been disenrolled, many because they were no longer eligible, or failed to provide necessary information. The decline is particularly evident in states with stricter guidelines and more efficient processing of redeterminations.
Impact of Medicaid Enrollment Declines
The completion of Medicaid redeterminations has led to substantial drops in enrollment across the United States. More than 35 million individuals were disenrolled, although Medicaid enrollment remains higher than pre-pandemic levels. Data from KFF shows that adult enrollment is 20% higher than in February 2020, while enrollment among children is up by 5%.
Despite these overall increases, many states have experienced steep declines in enrollment since the redeterminations began. These enrollment decreases are having a significant impact on healthcare access for vulnerable populations, particularly low-income individuals and families who depend on Medicaid for coverage.
States with the Largest Medicaid Enrollment Declines
Here are the states that have experienced the largest declines in Medicaid enrollment since the redetermination process began in March 2023, as reported by KFF.
Colorado: -32.7%
Colorado experienced the largest decline in Medicaid enrollment, with a staggering 32.7% drop. This can be attributed to the state’s rigorous review process, as many beneficiaries either failed to renew their coverage or were deemed ineligible.
Utah: -31.2%
Utah follows closely behind with a 31.2% decrease in enrollment. The state has actively worked to complete redeterminations, resulting in the disenrollment of thousands of individuals who were no longer eligible for coverage.
Montana: -30.2%
Montana saw a significant 30.2% drop in Medicaid enrollment. The state’s focus on accurate redeterminations and strict eligibility criteria has contributed to this decline.
Texas: -28.7%
Texas, with one of the largest Medicaid populations in the country, saw a 28.7% decrease in enrollment. This drop is likely due to the large volume of redeterminations that needed to be processed and the complexity of the state’s Medicaid program.
Idaho: -28.6%
Idaho also saw a sharp decline in Medicaid enrollment, with a 28.6% drop. The state prioritized redetermination efforts early in the process, leading to many disenrollments for individuals who no longer qualified for Medicaid.
Other states that saw significant declines in Medicaid enrollment include:
– New Hampshire: -27.2%
– Oklahoma: -25.7%
– Arkansas: -25.2%
– North Dakota: -23.4%
– Florida: -22.3%
What’s Next for Medicaid Enrollment?
While most states have completed their Medicaid redetermination process, some, including North Carolina, Alaska, the District of Columbia, and New York, are still working through their backlog. North Carolina is set to complete its process by November 2024, while Alaska and D.C. will finish in 2025. New York has yet to establish a final date.
As these states finalize their redetermination efforts, we may see further declines in enrollment. However, Medicaid enrollment remains higher than pre-pandemic levels, and future policy changes could influence the program’s growth or decline.
FAQs
1. What is Medicaid redetermination?
A. Medicaid redetermination is the process of reviewing beneficiaries’ eligibility to ensure they meet the requirements for Medicaid coverage. States typically conduct these reviews annually but paused them during the COVID-19 pandemic.
2. Why is Medicaid enrollment declining?
A. Enrollment is declining because states have resumed redetermination processes, which were paused during the pandemic. Many individuals no longer qualify or failed to renew their coverage.
3. Are all states done with Medicaid redeterminations?
A. No, while most states have completed the process, some, such as North Carolina, Alaska, and the District of Columbia, are still working through their redeterminations.
4. How does Medicaid enrollment in 2024 compare to pre-pandemic levels?
A. Despite the recent declines, Medicaid enrollment in 2024 is still higher than in 2020. Adult enrollment is up by 20%, and children’s enrollment is 5% higher.
Conclusion
The resumption of Medicaid redeterminations has led to a 14.3% decline in overall enrollment since March 2023. Several states have seen particularly large declines, with Colorado, Utah, Montana, and Texas experiencing some of the most significant drops. Despite these decreases, Medicaid enrollment remains higher than pre-pandemic levels, and the program continues to provide essential healthcare coverage for millions of Americans. As the process continues in states like North Carolina and Alaska, Medicaid enrollment figures may see further shifts.
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