Report Estimates 6.7M Children May Lose Medicaid Coverage by April 

A new report from researchers at the Georgetown University Health Policy Institute finds that children will suffer if their parents and caregivers in Medicaid and the Children’s Health Insurance Program are not eligible for redetermination, as the coverage requirement may be set to expire in April.

To conduct the study, researchers examined Medicaid child enrollment through June 2021 of 33.3 million children from Centers for Medicare and Medicaid Services data, as well as state administrative data. 

Currently, half the children in the U.S. are insured through Medicaid or CHIP, with the majority in Medicaid. 

During the COVID-19 public health emergency, a continuous coverage requirement allowed children to have greater stability in their Medicaid coverage but that is set to expire as soon as April 2022.

When that happens, states will have to recheck eligibility for everyone enrolled in Medicaid, including children, which researchers estimate could result in 6.7 million children losing Medicaid coverage.

According to researchers, this could happen in one of two ways. Either children will become eligible for another public coverage program but get lost in the transition or they could remain eligible for Medicaid but still lose coverage for procedural reasons, such as not responding to a mailed request for verification by the state. 

The mass eligibility redetermination will vary for children depending on where they live and how states they live in handle the transition, but researchers estimate that children in Delaware, Florida, Georgia, Missouri, Nevada and Texas are especially at risk of losing health insurance during this period.

There is good evidence from several states that changes in coverage requirements lead to uninsured children, as seen with CHIP in Utah.

Researchers said several states received approval from CMS to impose a disenrollment freeze on its separate CHIP, in addition to Medicaid. 

But when CMS told these states, including Utah, to list the CHIP freeze in late 2020, Utah could not locate many of the families. As a result, around 41% of the children enrolled in CHIP dropped off.

Alexa can be reached at [email protected]