The share of the population without health insurance is at a record low of 7.7%, according to new federal data. Over 6 million previously uninsured Americans have secured coverage since 2020.
But this historic uninsured rate is already rising, as states continue to boot people from Medicaid after pausing such disenrollments during the pandemic. In March 2020, Congress directed state Medicaid programs to keep people “continuously enrolled” for the duration of the Covid-19 public health emergency. Last December, lawmakers ended the continuous coverage requirement. Since April 1 of this year, state officials have been “redetermining” whether people are eligible for the program — and disenrolling individuals deemed ineligible.
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Since the beginning of April, more than 9 million people have been jettisoned from Medicaid as of October 2023. In all, up to 18 million Americans could lose Medicaid coverage through June 2024. Fortunately, the vast majority of these folks have a number of options for obtaining affordable coverage. They just have to know where to look.
First, they should double-check whether they’ve been booted by mistake.
The federal government estimates that about 6.8 million people who will be disenrolled from Medicaid are actually still eligible. They may be victims of an administrative error. For example, many states have disenrolled people because they haven’t been able to get in touch with them to verify their eligibility — perhaps because they don’t have an up-to-date address or phone number.
A person who is wrongfully disenrolled always has the option to re-apply — and may even be able to gain retroactive coverage for any care they receive three months prior to their application.
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Second, if you’re unemployed, working part time, or your employer doesn’t offer health insurance, then consider a government exchange plan. Nearly 3 million people on track to lose Medicaid coverage because of redetermination will qualify for subsidized coverage through the federal marketplace or their state’s insurance exchange. Some may even be able to secure free or near-free coverage. Federal officials last year estimated that six in ten members of this group would qualify for plans with zero premium.
The exchanges offer a special enrollment period for people who lose Medicaid. So there’s no need for people to wait to sign up for new coverage. And with open enrollment starting November 1, everyone — regardless of whether or when they lost Medicaid — has an easy opportunity to evaluate their healthcare options and sign up for a new plan.
The exchanges can be overwhelming. This year, the average consumer could choose from among five insurers offering 88 plans. That’s a lot to sort through — different deductibles, provider networks, cost-sharing responsibilities, and lists of covered benefits and drugs.
Insurance brokers — both online and offline — can be crucial allies for people looking to make sense of all those choices. They can simplify the process by integrating enrollment & tax credits into their experiences which will help consumers easily compare options and select a health plan that works for them at the lowest possible price. Certain healthtech companies can even check whether someone is still eligible for Medicaid.
Finally, many individuals who lose Medicaid coverage may be able to procure private coverage through an employer — whether their own or their spouse’s. As many as 6 million set to lose Medicaid during the redetermination process are eligible for health insurance through their place of work.
Most won’t need to wait for open enrollment. Individuals who lose Medicaid have a “special enrollment right” under the Health Insurance Portability and Accountability Act, meaning they can enroll in employer-sponsored insurance outside of open enrollment.
People who lose Medicaid need not go without coverage. With just a bit of legwork, they can find affordable — even free — health insurance.
Photo: turk_stock_photographer, Getty Images
Bryan Giaimo is the general manager of Platform at Stride Health.
