People of Color Hit Hardest After COVID-19 Medicaid Unwinding


Three-quarters of disenrollments were due to procedural reasons such as incomplete applications, application errors and inaccurate contact information.

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Black and Hispanic individuals were twice as likely to not complete the Medicaid re-enrollment processes at the end of continuous Medicaid enrollment last year, according to a new research letter published yesterday in JAMA Internal Medicine by researchers at Harvard Medical School, Northwestern University and Oregon Health and Science University.

During the COVID-19 pandemic, 94 million Americans were automatically enrolled in Medicaid during continuous enrollment. Since continuous enrollment ended on March 31, 2023, 10 million people have lost coverage as states began to redetermine eligibility for Medicaid.

To estimate adult Medicaid disenrollment, researchers used seven waves of the U.S. Census Bureau’s Household Pulse Survey, which measures how social issues are impacting households across the country.

The most recent survey data assessed was from Oct. 2023 and contained 32,445,868 individuals. The median age of respondents was 51. White enrollees made up 52% of survey respondents, Black individuals made up 17.7%, Hispanics made up 19.9%, 4.5% were Asian and 5.9% were classified as “other.”

Researchers focused on the following questions from the surveys:

1). Are you currently covered by any of the following types of health insurance or health coverage plans?

2). What was the main reason you no longer have Medicaid? Which included the option ‘I could not complete the renewal process.’

The option ‘I could not complete the renewal process' was the most common reason for losing Medicaid coverage.

“This finding is consistent with state-collected data suggesting that early coverage losses are secondary to renewal processes rather than changes in Medicaid eligibility,” first author Kranti C. Rumalla, a medical student at the Feinberg School of Medicine, Northwestern University, Chicago, wrote in the letter.

Researchers said policymakers have the power to fix this.

“Addressing these barriers may include more transparent race and ethnicity data reporting, expedited administrative processes, expanded renewal assistance, and prioritized redeterminations for beneficiaries most likely to be ineligible,” Rumalla said. “States could also simplify the renewal process, including prepopulating renewal forms with enrollee information or allowing more time for forms to be returned.”

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