On Thursday, The Georgetown University Center for Children and Families released a report that estimates 6.7 million children are at high risk of becoming uninsured when the Medicaid continuous coverage public health emergency requirement is lifted.
The report titled: “Millions of Children May Lose Medicaid: What Can Be Done to Help Prevent Them From Becoming Uninsured?” explores how many children will be impacted, what policies can minimize disruption to children’s coverage, and identifies states where children are at greater risk of losing their coverage.
The majority of the children in the United States (40 million) that are insured through Medicaid had stability during the COVID-19 pandemic thanks to a continuous coverage requirement that was established by Families First Coronavirus Response Act.
However, that protection is likely to expire sometime in 2022 – perhaps as soon as April.
What does this mean?
States will have to recheck eligibility for everyone enrolled in Medicaid, including children.
Disenrollment due to administrative barriers or fluctuations in family income are the top reasons children lose Medicaid.
This will lead to at least 6.7 million children losing their Medicaid coverage, leaving them at risk of becoming uninsured for some period of time.
For reference, Georgetown University pulled data from the Census Bureau which shows that in 2019 (the last year for which data is available), 4.4 million children were uninsured.
“It is critical that state and federal policymakers act to minimize coverage losses, make data available to the public, and intervene quickly if children begin to lose coverage inappropriately,” warned co-author Tricia Brooks, research professor at the Georgetown University McCourt School of Public Policy a co-author of the report.
In which states are children more at risk?
The outcomes of the mass eligibility redetermination will vary for children depending on where they live and how well their states handle the transition.
According to the report, there are five factors that put children at greater risk of losing their coverage:
- States with separate CHIP programs.
- States that charge premiums for CHIP coverage.
- States that do not provide 12 months of continuous coverage for children in Medicaid.
- States that process less than half of their renewals using existing data sources.
- States with premiums or enrollment fees below 200% FPL.
The states that have garnered all five red flags and where children are at greater risk are Delaware, Florida, Georgia, Missouri, Nevada, and Texas.
According to an earlier report from Georgetown University, 995,000 Texas Children were uninsured in 2019. Overall, the state had both the highest number and the highest rate of uninsured children.
In Texas, 12.7% of children do not have health insurance. While one of the main coverage sources for those who are insured is Medicaid/CHIP, with a percentage of 36.4.
From 2016-to 2019 these numbers saw a statistically significant increase, which will most likely see a new surge due to this unprecedented event.
What actions should be taken to avoid coverage losses?
States should follow up with enrollment when action is required to avoid a loss of coverage and work with managed care organizations to update contact information and support the renewal process, as suggested by the report.
It also discusses ways to be better prepared, including balancing a timeline to catch up on delayed actions with workforce capacity.