Still, state health officials worry that people may get left behind and that the state’s all-time low 7% uninsured rate could spike.
“We acknowledge that this is going to be a bumpy road,”
Federal health insurance subsidies will help prevent people from falling through the cracks, he said.
Almost three years ago, as COVID-19 sent the national economy into free fall, the federal government agreed to send billions of dollars in extra Medicaid funding to states on the condition that they stop dropping people from their rolls.
But legislation enacted in December will be phasing out that money over the next year and calls for states to resume cutting off from Medicaid people who no longer qualify.
Now, states face steep challenges: making sure they don’t inadvertently disenroll people who are still entitled to Medicaid and connecting those who no longer qualify to other sources of coverage, such as subsidized health plans on the Affordable Care Act marketplaces.
Even before the pandemic, states struggled to stay in contact with Medicaid recipients, who in some cases lack a stable address or internet service, do not speak English, or don’t prioritize health insurance over more pressing needs.
Ordinarily, people move in and out of Medicaid all the time. States, which have significant flexibility in how they run their Medicaid programs, typically experience significant “churn” as people’s incomes change and they gain or lose eligibility.
The so-called unwinding will play out over more than a year.
The Biden administration has predicted that 15 million people — 17% of enrollees — will lose coverage through Medicaid or CHIP, the closely related Children’s Health Insurance Program, as the programs return to normal operations.
While many of the 15 million will fall off because they no longer qualify, nearly half will be dropped for procedural reasons, such as failing to respond to requests for updated personal information, according to federal estimates.
Millions of people losing Medicaid coverage will be eligible for free or low-cost coverage through the ACA marketplaces, but choosing a plan is complicated.
Unlike Medicaid, so-called Obamacare plans often include deductibles and copayments — though some people, depending on income, can get financial help to lower those expenses.
Enrollees will have to agree and pay a premium if they don’t qualify for a free plan.
But for those who don’t qualify for a zero-premium private plan, the premium could be as low as