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Many Children May Have Lost Medicaid Coverage Because of State Errors

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Federal officials have discovered major errors in the systems and procedures that some states have been using to verify eligibility for Medicaid, possibly leading to a substantial number of children losing health coverage despite still being eligible for it.

State agencies have been “unwinding” a pandemic-era policy that allowed people to keep their health insurance coverage through Medicaid, the joint federal-state program for low-income Americans, without regular eligibility checks.

After that rule lapsed in April, at least a million children have lost coverage, researchers have found, despite having significantly higher eligibility limits than adults.

In a letter addressed to state Medicaid agencies, Daniel Tsai, a senior official at the Centers for Medicare and Medicaid Services, warned that technical errors may be to blame for many disenrollments.

Mr. Tsai told reporters in a press briefing Wednesday that the problem was “a very specific systems glitch that we think has tremendous implications for eligible kids and families maintaining coverage.”

Many states are conducting what are known as “ex parte” renewals, or automatic checks that rely on databases, such as state wage records, to determine whether people are still eligible for Medicaid coverage.

States are required to vet the eligibility of recipients individually. But after conducting the automatic renewals, some states appear to have sent renewal forms requesting information for all household members and to have disenrolled everyone if the forms are not returned, including those who should have been deemed eligible through the ex parte process, Mr. Tsai wrote in the letter.

Children may have been disproportionately punished by this practice, officials said on Wednesday.

The administration ordered states that identify this error to fix their eligibility systems, to pause removals and to reinstate those who had been affected by the mistakes.

The letter amounted to one of the most confrontational actions that federal officials have taken since the start of the unwinding, which has led to over 5.5 million people losing coverage, according to state data analyzed by KFF, a health policy research organization.

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Sahred From Source link Health

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