Health

Following State Errors, Nearly 500,000 Americans Will Regain Health Insurance

Nearly 500,000 people, many of them children, will keep Medicaid and Children’s Health Insurance Program coverage after state officials discovered major errors in their procedures for reviewing eligibility for the programs, federal officials said on Thursday.

After a pandemic-era policy that guaranteed Medicaid coverage lapsed in April, states began checking to see whether tens of millions of Americans covered by the programs still qualified, removing them from the rolls if their incomes had surpassed program limits, among other reasons.

Many states conducted the checks with software that automatically verified whether people were still eligible, using government databases to verify income levels. But 30 states, federal officials confirmed on Thursday, had been vetting statuses incorrectly.

As a result, legions of children lost health coverage when their parents did not return the required forms to confirm the eligibility of everyone in a household. The Biden administration last month warned states about the problem, giving them two weeks to report whether they had improperly disenrolled people.

“This will help strengthen access to Medicaid not just during this very challenging renewal transition, but also in the long term,” Chiquita Brooks-LaSure, the Medicare and Medicaid chief, said at a news conference on Thursday.

The unwinding of Medicaid enrollment has had catastrophic consequences for poor families and children across the country. More than seven million people have lost coverage through the program since the enrollment requirement ended in April, according to state data analyzed by KFF, a nonprofit health policy research group.

Nearly 1.4 million children have lost coverage in states that have shared enrollment figures broken down by age. Children have more generous eligibility limits for enrollment in Medicaid, and thus greater leeway to remain on the rolls.

It is still unclear how many children might have lost coverage because of the technical errors. Daniel Tsai, a senior Medicaid official, said at the Thursday briefing that it was likely a “significant portion” of the almost 500,000 Americans who are keeping their coverage.

States are still reviewing data on who improperly lost insurance, he said.

The Biden administration had ordered states that discovered the errors to halt what are known as procedural disenrollments, which occur when a recipient does not confirm eligibility with a state Medicaid agency, then loses coverage.

Mr. Tsai said that some states had fixed the problem rapidly and would soon be able to restart eligibility checks, “as long as they continue to have that fix in place and when they can guarantee that no eligible people are disenrolled because of the issue,” he said.

Other states, Mr. Tsai added, could take months to make the fixes and resume enrollment decisions.

In many of the 30 states identified on Thursday, fewer than 10,000 people were affected by the technical errors, according to a spreadsheet federal officials shared with reporters. But in Pennsylvania and Nevada, more than 100,000 people in each state were impacted.

Kristle Muessle, a spokeswoman at Nevada’s Department of Health and Human Services, said in a statement that roughly 114,000 people had regained Medicaid coverage after state officials learned of the erroneous disenrollments.

“Procedural denials have been paused while Nevada works on computer system enhancements,” she said.

The state figures published on Thursday were estimates, meaning that many more children may have been affected by the improper eligibility checks than is currently known. Some states that admitted to conducting the checks incorrectly are still assessing how many people were impacted, suggesting the total could be well over 500,000.

“The scope of this problem is large,” said Joan Alker, the executive director of the Georgetown University Center for Children and Families.

Still, she noted, the numbers cited by the Biden administration on Thursday left out children who may have unfairly lost coverage in other ways. “This is not the only problem we have,” Ms. Alker said.

In Texas, she noted, where officials have made only modest use of automatic renewals, many children were losing coverage because of faulty enrollment procedures the state had yet to correct. Nearly 900,000 Texans have lost coverage in the process so far, according to KFF, roughly 80 percent of them children.

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