Slow Response from Biden Administration as Millions Risk Losing Medicaid, Experts Warn

by Madison Thomas
Medicaid disenrollment

Advocates are raising alarms that the Biden administration’s lackluster response could lead to nearly 30 million vulnerable Americans being removed from the Medicaid program. This potential purge, largely due to flawed state reviews, is a concern highlighted by poverty experts who believe the administration isn’t taking adequate measures to intervene.

According to Avalere, a health consulting firm, these worries emerge amidst states reassessing the eligibility of 94 million Medicaid enrollees, a program designed for America’s most impoverished. This reevaluation has revealed numerous issues, such as lengthy wait times on Florida’s phone lines, convoluted forms in Arkansas, and erroneous removal of children from coverage in Texas.

Trevor Hawkins, a Legal Aid of Arkansas attorney, expressed frustration at the flawed process, having aided hundreds in Arkansas with their Medicaid eligibility. Despite raising concerns about misleading forms and the rapid disenrollment of approximately 420,000 individuals, the Centers for Medicare and Medicaid Services (CMS) have not addressed these issues.

Reports indicate that across the nation, advocates assisting the roughly 10 million already removed from Medicaid are witnessing widespread problems, sparking fears of systemic neglect.

The Health and Human Services Department acknowledged these challenges, especially in Texas, Florida, and Arkansas, which together account for a significant portion of disenrollments. The department emphasized its readiness to enforce actions if necessary.

Congress recently lifted a COVID-19 related policy that prevented Medicaid disenrollment, now requiring states to review each enrollee’s eligibility. HHS, led by Xavier Becerra, possesses the authority to penalize states or stop disenrollments if errors occur, though little information has been shared about any identified problems.

Earlier this year, HHS briefly halted disenrollments in 14 undisclosed states. In August, they announced that thousands of children had been mistakenly removed in 29 states, leading to mandated reinstatement.

Florida’s efforts to remove Lily Mezquita, a Miami resident and working mother, from Medicaid during her pregnancy, exemplifies the challenges many face. Despite numerous phone calls and explaining state law, she encountered resistance, eventually reinstating her coverage during preterm labor.

Avalere’s projections suggest up to 30 million people could lose Medicaid coverage, surpassing the Biden administration’s initial estimate of 15 million. The majority of these removals stem from procedural issues, indicating broader problems in state eligibility determination processes.

In Arkansas, public records showed over 70% were removed due to unreachable individuals or unreturned renewal forms. The state’s Department of Human Services countered by citing additional outreach efforts, while CMS has not requested a pause in disenrollments.

Similar challenges are seen in Florida and North Carolina, with long phone wait times and unresponsive local offices. In Texas, technical issues with websites and apps are causing many families to lose coverage without notification.

Graciela Camarena from the Children’s Defense Fund in Texas noted some positive interaction with CMS, despite ongoing issues. Meanwhile, Jennifer Wagner from the Center on Budget and Policy Priorities suggests that it might be time for CMS to shift from cooperation to enforcement with certain states.

The article, authored by Hunter and supported by the Robert Wood Johnson Foundation, is part of The Big Big News Health and Science Department’s coverage. The AP maintains full responsibility for the content.

Frequently Asked Questions (FAQs) about Medicaid disenrollment

What is the current issue with Medicaid disenrollment?

Nearly 30 million Americans are at risk of losing their Medicaid coverage due to flawed state reviews and a lack of adequate intervention from the Biden administration. This issue has emerged as states reassess the eligibility of Medicaid enrollees, uncovering problems such as long phone wait times, confusing forms, and wrongful coverage drops.

How many people have already been removed from Medicaid?

Approximately 10 million people have already been dropped from Medicaid, according to advocates. This number could rise to as much as 30 million, based on projections from Avalere, a health consulting firm.

What are the main problems identified in the Medicaid redetermination process?

Key issues include procedural errors like unreturned renewal forms, unreachable individuals, and technical glitches in state systems. These problems suggest broader challenges in how states determine Medicaid eligibility and communicate with enrollees.

What actions has the Health and Human Services Department taken in response?

The Health and Human Services Department has acknowledged the challenges, particularly in states like Texas, Florida, and Arkansas. They have emphasized their readiness to take enforcement actions if necessary and have already briefly paused disenrollments in 14 states earlier this year.

What authority does HHS have over state Medicaid programs?

The HHS, under Xavier Becerra, has the power to penalize states or halt disenrollments if it is found that people are being improperly removed from Medicaid. This authority was granted following the lifting of a COVID-19 policy that barred states from removing anyone from Medicaid during the pandemic.

How are individuals affected by these Medicaid disenrollment issues?

Individuals like Lily Mezquita in Florida, who faced challenges in maintaining her Medicaid coverage during pregnancy, exemplify the personal struggles many are facing. These include long wait times for phone support, confusing state communications, and out-of-pocket expenses due to delayed or denied coverage.

More about Medicaid disenrollment

  • Medicaid Enrollment and Disenrollment Policies
  • Avalere Health Consulting Firm
  • Health and Human Services Department Actions on Medicaid
  • Medicaid Eligibility and Renewal Processes
  • State-Specific Medicaid Challenges: Texas, Florida, Arkansas
  • Impact of COVID-19 Policies on Medicaid
  • Individual Stories of Medicaid Disenrollment Struggles
  • Legal Perspectives on Medicaid Enrollment Issues

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Samantha R. November 15, 2023 - 6:49 am

Is the administration even paying attention? these are real people struggling out here!

Mike T. November 15, 2023 - 11:49 am

why aren’t we hearing more about this in the news? seems like a major issue thats not getting enough attention.

David K November 15, 2023 - 3:29 pm

30 million, that’s a huge number, how did it get this bad, the states need to step up their game.

Linda Q November 15, 2023 - 6:03 pm

just read this, it’s heartbreaking, especially the story about the pregnant woman, can’t imagine going through that.

Jake M. November 15, 2023 - 11:15 pm

really concerning to see how many might lose their Medicaid, didn’t know it was this bad…


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