Hands Off Our Healthcare: Medicaid Issue Brief

Stop Disenrollment of Individuals and Families Eligible for Medicaid Coverage

When pandemic era protections expired last year, Medicaid protection and access was put in jeopardy. The process of determining eligibility, referred to as Medicaid Unwinding, began with startling results. On April 1, 2023 states could begin the process of removing Medicaid beneficiaries. Since that time, millions of adults and children have been terminated from the program – with communities of color bearing the brunt.

The NAACP called on states to take the necessary time to accurately determine eligibility for all enrolled. Since that time, over 10 million people have lost their health coverage. About 3 out of every 4 people who lost coverage may indeed still be eligible, but were terminated for purely administrative/procedural "red-tape" issues. Communities of color are significantly losing coverage at higher rates. The process of Medicaid redeterminations is going badly, and governors must be held accountable and stop disenrollment of individuals and families who remain fully eligible for Medicaid coverage. We are witnessing the single largest health coverage loss in our nation's history.

Background:

Medicaid is the single largest source of health coverage in the United States. It provides comprehensive medical coverage to over 92 million Americans including eligible adults, pregnant women, children, elderly adults and people living with disabilities. It ensures that all people have access to high-quality, affordable healthcare coverage.

When Congress passed the Families First Coronavirus Response Act, the most important provision prohibited states from dis-enrolling anyone involuntarily who was enrolled in Medicaid and Children's Health Insurance Program (CHIP) on or after March 18, 2020. This provision is known as Medicaid Continuous Enrollment. This requirement was a vitally important policy tool to avoid increases in the number of uninsured people during the pandemic. During this period, the nation's uninsured rate declined to a historic low of 8.0% in the first quarter of 2022. It is estimated that enrollment in Medicaid/CHIP increased by 23.3 million and reached nearly 95 million people from the period February 2020 to March 31, 2023.

Recommendations:

• Urge governors to immediately pause procedural Medicaid terminations to prevent millions of children, families, older adults, and others from losing Medicaid because of procedural reasons that often include nothing more than missing paperwork. States must commit to prioritizing healthcare for all.
• Advocate for states' elected leaders to make new commitments to Medicaid including using an automated Medicaid enrollment renewal process so eligible people get the coverage they deserve.
• Utilize the NAACP's Civil Rights Medicaid Scorecards for advocacy efforts. The state focused scorecards grade each governor on their handling of providing Medicaid coverage for their state's residents. Ultimately, states and their respective governors are evaluated based on their commitment to safeguarding the health of our communities by ensuring continued health coverage for all eligible individuals. The scorecards are designed to track this health coverage crisis, and be used to hold our elected officials accountable. Visit the NAACP site to access the scorecard to see how your state has measured up.

Our state leaders must make every effort to re-enroll those who have lost Medicaid coverage, leveraging available data to verify eligibility or providing readily accessible support to complete the paper

Failure to expand Medicaid and address coverage gaps is disproportionately harming people of color, further exacerbating existing health disparities. This is a preventable health equity disaster.