Medicaid Coverage: Millions of American Children at Risk of Losing Health Care Access

Medicaid chip Medicaid Coverage Children’s Health Insurance Program Continuous Enrollment Provision American kids losing insurance

By E.Baloyo , Parent Herald Feb 16, 09:42 pm

Photo: (Photo : Robyn Beck/ Getty Images)

Most American children's primary health insurance sources are Medicaid and the Children's Health Insurance Program (CHIP).

However, starting this spring, around 6.7 million children will likely lose their coverage as states resume eligibility reviews.

The surge in Medicaid enrollment during the pandemic was due to a relief provision passed by Congress.

But, with the continuous enrollment provision set to expire on April 1, lawmakers have given states the freedom to identify and remove recipients who do not meet the eligibility criteria.

Children's eligibility for Medicaid

According to CNN, the COVID-19 pandemic significantly impacted the health insurance coverage available in the United States. The number of children who qualified for Medicaid and CHIP coverage during the pandemic varied from state to state.

A 17.5 percent increase in the number of children covered by Medicaid and CHIP can be compared to the previous month of February 2020, just before the pandemic began.

Indiana had the most significant surge, with a nearly 45 percent increase in children's Medicaid and CHIP coverage.

Furthermore, places like Georgia, North Dakota, and Missouri saw their child enrollment grow exponentially.

As of August, more than 34 million children were covered by Medicaid, and another 4 million children were enrolled in CHIP, which Medicaid funds.

Unfortunately, many people will risk losing their Medicaid coverage since enrollees in the program will now be subjected to a thorough eligibility review.

However, instances of this eligibility may vary from case to case or state to state since some children can continue to be qualified to receive the insurance even if their parents are not.

According to Very Well Health, Medicaid is a joint federal-state program that provides health coverage to eligible low-income individuals and families, including children, pregnant women, and people with disabilities.

Medicaid is funded by both the federal government and individual states, and it covers a wide range of services, including doctor visits, hospital stays, prescription drugs, and more.

On the other hand, CHIP is a federal-state partnership program that provides health coverage to uninsured children in families with incomes too high to qualify for Medicaid but too low to afford private insurance.

When the continuous enrollment requirement ends, it is estimated that nearly three-quarters of the children projected to be dropped will remain eligible for Medicaid, but they may lose coverage due to administrative issues, such as their parents not submitting the necessary paperwork or procedural errors.

Ending Medicaid's continuous enrollment provision

As a direct response to the COVID-19 pandemic, the United States Congress has adopted the Families First Coronavirus Response Act (FFCRA), as reported by the KFF.

This act included a provision requiring Medicaid programs to keep individuals enrolled until the end of the month when the COVID-19 public health emergency (PHE) ended.

In exchange for this provision, the federal government provided enhanced funding to Medicaid programs. The continuous enrollment provision played a key role in the substantial growth in Medicaid enrollment compared to pre-pandemic levels, resulting in a decline in the uninsured rate.

The continuous enrollment provision is a policy response to the pandemic that allows individuals already enrolled in Medicaid to maintain their coverage for longer, even if their eligibility circumstances change.

Ordinarily, individuals must periodically renew their Medicaid coverage and may lose their benefits if they no longer meet the eligibility criteria.

This provision has helped to ensure that people who need healthcare coverage can continue to receive it during this difficult time.

Once the continuous enrollment provision ends, however, there is a risk that millions of people could lose their Medicaid coverage, reversing recent gains in coverage.

This sudden change has sparked concerns about the health and well-being of millions of American children and families that rely on Medicaid and CHIP for their healthcare needs.

Many families who were able to access health insurance during the pandemic are now at risk of losing it, potentially leading to a surge in uninsured children.