KFF: At least 2.8M Americans & counting have lost coverage for procedural reasons so far #MedicaidUnwinding

It's been over six weeks since the last time I checked in on how many Americans had lost Medicaid or CHIP coverage due to the ongoing Medicaid Unwinding process playing out nationally. At the time, "only" 612,000 people had been confirmed to have lost coverage purely due to procedural/red tape reasons (as opposed to others who lost coverage after being determined ineligible any longer).

The Kaiser Family Foundation (KFF) has taken up the mantle on this front, and the data so far, while still limited, is pretty much as bad as many healthcare advocates feared. Since then, a lot more data has been collected and the numbers have grown dramatically:

• At least 3,773,000 Medicaid enrollees have been disenrolled as of July 31, 2023, based on the most current data from 39 states and the District of Columbia. Overall, 39% of people with a completed renewal were disenrolled in reporting states while 61%, or 5.7 million enrollees, had their coverage renewed (three of the reporting states do not provide data on renewed enrollees). Because not all states have publicly available data on total disenrollments, the data reported here undercount the actual number of disenrollments.

• There is wide variation in disenrollment rates across reporting states, ranging from 82% in Texas to 8% in Wyoming. Differences in who states are targeting with early renewals as well as differences in renewal policies and systems capacity likely explain some of the variation in disenrollment rates. Some states (such as Texas and South Carolina) are initially targeting people early in the unwinding period that they think are no longer eligible or who did not respond to renewal requests during the pandemic, but other states are conducting renewals based on an individual’s renewal date. Additionally, some states have adopted several policies that promote continued coverage among those who remain eligible and have automated eligibility systems that can more easily and accurately process renewals while other states have adopted fewer of these policies and have more manually-driven systems.

• ...Across all states with available data, 74% of all people disenrolled had their coverage terminated for procedural reasons. There is also wide variation in rates of procedural disenrollments across states reporting this breakout, ranging from 96% in New Mexico to 33% in Colorado. Procedural disenrollments are cases where people are disenrolled because they did not complete the renewal process and can occur when the state has outdated contact information or because the enrollee does not understand or otherwise does not complete renewal packets within a specific timeframe. High procedural disenrollment rates are concerning because many people who are disenrolled for these paperwork reasons may still be eligible for Medicaid coverage.

In short, nearly 3.8 million have lost coverage in these 39 states, of which at least 2.79 million are for purely procedural/red tape reasons. If this population was its own state, it'd be the 37th largest in the United States...and again, it's likely much higher than that.