74% of Terminated Medicaid Enrollees Were Cut for Procedural Reasons

August 25, 2023 - Millions of Medicaid enrollees have been disenrolled from Medicaid during the redetermination process, largely for procedural reasons, a KFF tracker noted.

As of August 23, 2023, over 5.36 million Americans were disenrolled from Medicaid. The data spans 45 states plus the District of Columbia obtained from reports to CMS, state websites, and CMS data.

Nearly four out of ten individuals who completed the renewal process were disenrolled (37 percent), which is a conservative assessment because not all states included their total disenrollment count in public data. The remaining 8.8 million Americans had their coverage renewed when they finished the renewal process.

Among those with terminated coverage, 74 percent were terminated due to procedural reasons. Procedural causes for termination do not necessarily indicate that the individuals are ineligible for Medicaid coverage. Such terminations could be the result of enrollees not turning in paperwork on time or the Medicaid agency misplacing their paperwork, according to the Center on Budget and Policy Priorities.

The number of procedural disenrollments would be lower if the calculations include successful renewals and pending renewals, researchers shared. Nevada’s disenrollment rate, which is 95 percent under KFF’s initial calculations, would then become 53 percent if these statistics were incorporated.

Texas had the highest disenrollment rate among the reporting states. Almost three-quarters of all completed Texas renewals—617,000 people—were disenrolled. Wisconsin had the second-highest disenrollment rate at 62 percent followed by Montana and Idaho which each disenrolled 60 percent of their completed renewals.

These results differed starkly from states like Wyoming and Michigan which only disenrolled eight and nine percent of their completed renewals, respectively.

However, researchers indicated that states like Texas and South Carolina have taken an approach that may make their results look particularly severe in contrast to Wyoming and Michigan’s disenrollment rates. These states targeted populations of enrollees who were most likely to be ineligible or who failed to respond to pandemic-era renewal notices.

Among the states that reported disenrollment by age, 43 percent of the disenrolled individuals were children. At least 1.14 million out of over 2.65 million disenrollments were children.

Nationwide, as of April 2023, Medicaid’s enrollment growth far exceeded growth in CHIP. Medicaid’s enrollment growth reached 35 percent, whereas CHIP’s growth declined to 3.6 percent from a three-year high of 5.5 percent in February 2023. In tandem with this trend, adult enrollment growth exceeded child enrollment growth in Medicaid or CHIP.

Additionally, 25 percent of enrollees in the 18 states reporting renewal outcomes have been ex parte renewals. Another 21 percent were renewed by renewal form. A quarter of all enrollees were terminated for procedural reasons while seven percent were deemed ineligible. Finally, 22 percent are still in process.

Despite disenrollments, 94.2 million people were enrolled in Medicaid or Children’s Health Insurance Program (CHIP) in April 2023, 32 percent more than pre-pandemic. The incline has been steady, without major spikes or cliffs. Every state has experienced an increase in Medicaid or CHIP enrollment between February 2020 and April 2023.

Experts anticipated widespread disenrollment when the public health emergency ended and redeterminations started again. Early estimates projected 18 million enrollees would lose Medicaid coverage.

The key concern is whether individuals who are eligible for Medicaid will be disenrolled unnecessarily due to procedural reasons. CMS paused redeterminations in six states due to various procedural barriers.

Researchers expected that disenrolled Medicaid beneficiaries will choose employer-sponsored health plan coverage.