The Biden administration warns nine governors about Medicaid losses among children
The Biden administration Monday warned the governors of nine states of unusually high Medicaid coverage losses among children, indicating that officials failed to protect young, low-income Americans as they winnowed out program roles.
Xavier Becerra, the secretary of Health and Human Services, wrote letters to the leaders of the states that had highest number or percentage of Medicaid coverage losses among children through September, after a federal policy that required states to keep people in the program expired.
The calls to state leaders were also a call to expand Medicaid under the Affordable Care Act. Recipients of the letters included Governor Ron DeSantis of Florida, Governor Brian Kemp of Georgia and Governor Greg Abbott of Texas. All three are Republicans who lead states that have not expanded Medicaid and where hundreds of thousands of children have lost coverage this year.
The nine states accounted for about 60 percent of enrollment declines in Medicaid and the Children’s Health Insurance Program (CHIP) through September, federal health officials said.
Governors must “ensure that no eligible child loses health insurance because of red tape,” Mr. Becerra said during a news conference Monday morning. He called on state officials to do so facilitate transfers from children from Medicaid to CHIP; shortens waiting times in the call center; And adopt special rules that allows states to relax their procedures for keeping children enrolled in Medicaid.
The letters, which the Biden administration released Monday with new data on child Medicaid losses through September, signaled a new aggressive stance during the so-called phaseout of the federal Medicaid requirement.
The process was riddled with technical difficulties, paperwork errors and delays, causing thousands of poor children to lose health care coverage.
Federal officials have been reluctant to attack governors or state Medicaid officials as they worked to resolve these bureaucratic problems. Some advocacy groups and public health experts have said the administration has not been aggressive enough in calling for, halting and resolving lawsuits that led to large numbers of children losing coverage in some states.
In a message on XGov. Sarah Huckabee Sanders of Arkansas, a Republican to whom Mr. Becerra wrote on Monday, accused the Biden administration of undertaking a “politically motivated PR stunt, accusing us of limiting access to Medicaid.”
‘That is not true. During the resolution process mandated by federal law, the Biden administration sent letters to certain states to pause their resolution, but Arkansas was never one of them,” she wrote. “Arkansas complies with state and federal laws while Biden plays politics on Christmas.”
Child Medicaid enrollment has declined by more than three million this year a separate analysis published Monday by the Georgetown University Center for Children and Families.
Because of data delays and differences in how states report Medicaid losses, that figure is likely a significant undercount.
In total, the number of Medicaid enrollments has fallen by almost eight million, according to the researchers. Nearly seven million children could be uninsured for at least some time as a result of the settlement, according to the Georgetown researchers, which equates to nearly one in 10 nationwide.
Through September, Florida, Texas and Georgia experienced the biggest declines in child Medicaid enrollment nationwide, according to data shared Monday by federal health officials. Federal health officials noted Monday that the 10 states that did not expand Medicaid under the Affordable Care Act had disenrolled more children than all the states that did so combined.
Stacey Pogue, a senior policy analyst at Every Texan, a research and advocacy group, said Monday that thousands of children in Texas are still waiting for decisions from state Medicaid officials, who face a significant backlog of applications.
“We didn’t have the staff we needed. We didn’t have the necessary technology,” Ms Pogue said.
According to KFFa nonprofit health policy research group, more than 70 percent of people who lost Medicaid this year did so for procedural reasons, such as when a family did not return paperwork confirming their eligibility.
Children have broader eligibility limits for Medicaid and CHIP, suggesting that many of those who lost coverage this year should have remained eligible for some form of coverage.
Researchers have only shown that a small percentage of children have switched to CHIP, a sign that states have not done enough to facilitate these transfers.
Federal officials also presented figures Monday showing there was a clear correlation between fewer Medicaid losses and Medicaid adoption special exemptions from the Centers for Medicare and Medicaid Services; states requested the waivers to ease the eligibility review process.
The Biden administration said Monday that there are exemptions, including nearly 400 have been approved so farwould be extended until 2024.
Robin Rudowitz, the director of the Program on Medicaid and the Uninsured at KFF, said the waivers had allowed states to use other government benefit programs to automatically verify Medicaid eligibility, and to allow managed care organizations the authority to assist program recipients in completing application forms.
Some states have sought even more ambitious versions. Kentucky and North Carolina recently extended access to Medicaid for children by 12 months.
States are doing “so many things at once that it’s hard to break down what makes the biggest difference,” Ms. Rudowitz said. The data the Biden administration presented Monday, she added, “was an attempt to tie some of the specific policies to what might happen.”