With the expiration of the COVID-19 public health emergency, states are finally able to remove people from Medicaid who are not eligible for the program under the law. Some are taking full advantage.
A recent analysis by the Kaiser Family Foundation found that at least 565,000 patients in 12 states have been disenrolled from Medicaid. Nearly 250,000 of them are in Florida. Millions more disenrollments will likely follow, according to federal estimates.
Democrats have branded this purge of Medicaid enrollment as a moral atrocity. That's ridiculous. It's a return to sanity, where states ensure that people receiving government benefits are actually eligible for them. Taxpayers should demand no less.
The Families First Coronavirus Response Act, which was signed into law in the early days of the pandemic, required states to maintain coverage for all current and future Medicaid recipients until the end of the public health emergency, even if they became ineligible under the pre-pandemic terms of the law. The feds temporarily increased the share of Medicaid that they'd pay for to help states with the cost.
As a result, Medicaid enrollment exploded. Between February 2020 and March 2023, the program's rolls grew by more than 23 million to nearly 95 million, according to estimates from the Kaiser Family Foundation.
Now that the public health emergency has ended, those extra federal dollars are going away, and states can discontinue coverage for those who are ineligible. A report by the Department of Health and Human Services from August of last year projected that about 15 million people would lose Medicaid coverage.
For Democrats, a world in which fewer Americans depend on the government for health insurance is simply unacceptable. Surely, their thinking goes, all these patients would be much better served by remaining wards of the state and continuing to let taxpayers cover the tab for their medical care.
But most Americans who lose Medicaid coverage will be able to secure insurance through the employer or individual market. That private coverage will be far superior to Medicaid — and may not even cost them much.
After all, there's a reason these 15 million Americans aren't eligible for Medicaid anymore. In all likelihood, they earn too much to qualify or have an offer of employer-sponsored coverage.
That was the finding of a September 2021 study by the Urban Institute. According to that report, of the 15 million people likely to lose Medicaid coverage post-PHE (Public Health Emergency), around one-third would be eligible for subsidized coverage on Obamacare's marketplaces — which means they will be forced to pay no more than 8.5% of their income on health insurance.
Many will pay much less than that — or could even qualify for zero-premium plans.
What about the remaining two-thirds of newly disenrolled Medicaid patients? The 2021 Urban Institute analysis projected that nearly all of them will have access to some form of employer-provided coverage, whether through their own jobs or someone in their family.
A more recent Urban Institute study is only somewhat less optimistic. According to that analysis, from December 2022, about 18 million Americans will lose Medicaid in the months ahead. Of those, 9.5 million will transition to employer-sponsored insurance, another million will get covered on the exchanges, and about 242,000 will purchase off-exchange plans.
As for the rest, some of these patients will move to another form of government health coverage, and 3.2 million children will get coverage through the Children's Health Insurance Program.
Add it all up, and 3.8 million Americans will go uninsured as a result of the disenrollment according to the Urban Institute's most recent projections. But of this group, 1.5 million will qualify for Obamacare exchange subsidies, and so can purchase taxpayer-funded coverage on the marketplaces should they choose.
This leaves just over 2 million Americans without coverage options — a far cry from the 18 million figure at the heart of Democrats' fear-mongering.
Medicaid was never meant to cover nearly one-third of the American population, as it ended up doing during the pandemic. Even the federal government has declared the COVID-19 emergency over. It's long past time Medicaid did the same.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.
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