- As many as 6.7 million children, along with millions of adults, stand to lose Medicaid coverage when the public health emergency expires, according to an analysis from the Georgetown University McCourt School of Public Policy Center for Children and Families.
- Medicaid continuous coverage protection, a provision of the Families First Coronavirus Response Act, has been a key healthcare safety net for children in states that have not expanded Medicaid under the Affordable Care Act. Uninsured rates for children in those states, the largest of which are Texas, Florida and Georgia, have remained mostly stable during the pandemic likely due to the continuous coverage provision, the report said.
- Congress may provide a solution by requiring 12 months of continuous coverage for children in Medicaid and the Children's Health Insurance Program, as the House did in the Build Back Better bill passed last fall, the researchers said. Most of the 12 non-expansion states have enacted this policy, while Florida, Georgia and Texas have not.
When millions of Americans lost employer-sponsored health insurance in the economic slowdown caused by COVID-19, the Medicaid safety net and the ACA marketplace offerings helped keep uninsured rates stable at about 8.6% to 9.7%.
Enrollment in Medicaid rose by about 18% between February 2020 and June 2021, with 12.5 million people gaining coverage after the more flexible regulations were put in place during the pandemic. Medicaid and CHIP cover half of the nation's children and enrollment in the program is at a record high of about 86 million people, according to the Georgetown report.
The Families First Act, signed into law in March 2020, prevents states from disenrolling anyone involuntarily from Medicaid coverage. People can lose coverage if their income has increased since they enrolled, or through a procedural denial.
The COVID-19 public health emergency has been extended until July 15. When it does expire, states will begin the process of checking eligibility of Medicaid enrollees.
A survey by the National Association of Community Health Centers released late last year found providers are concerned that rolling back Medicaid coverage after the public health emergency expires could severely curtail patient care. Almost all (90%) of the centers indicated they were able to provide more services due to regulatory flexibility during the pandemic to patients who would have otherwise gone without care.
Patients in the 12 states that have yet to expand Medicaid are expected to be especially hard-hit when the public health emergency expires, potentially losing benefits or facing higher healthcare costs, the National Association of Community Health Centers has reported.
Texas, Florida and Georgia have uninsured child rates higher than the national average with Texas and Florida alone accounting for 41% of the country's uninsured children in 2019, according to the Georgetown researchers. All three states have policies and structures in place that put children at higher risk of losing coverage once the public health emergency is over, they said.
When the continuous coverage requirement is lifted, state and federal systems likely will be overwhelmed by the mass event and children whose parents lose coverage during the transition will suffer, the report said.
"The silver lining of the pandemic has been that lower-income families have been assured of stable Medicaid coverage for their children. Policymakers should build on this success and not allow children to slip backwards," the researchers said.