Detrimental Impact of Medicaid Unwinding
by Elizabeth “Issie” Karan, Hemophilia Alliance Legal Counsel

As a reminder, as part of the COVID-19 public health emergency (PHE), state Medicaid programs were not allowed to conduct the typical, annual re-determination process for beneficiaries (i.e., state Medicaid programs could not remove anyone from their rolls). Now and over the next nine months, every single person enrolled in Medicaid – currently approximately 90 million people – will need to have their eligibility redetermined. And the process is not going well.

Last month, the Centers for Medicare & Medicaid Services (CMS), with the Department of Health and Human Services (HHS), released its first monthly Medicaid unwinding data report. According to the report, more than 3.8 million people lost Medicaid coverage over the past few months, likely a significant underestimate given the limited data available. Over 500,000 of those who lost coverage are children. Equally concerning is that most people lost coverage because of administrative issues. Based on the data that the Kaiser Family Foundation has collected, 75% of all people disenrolled from Medicaid had their coverage terminated for procedural reasons, meaning they lost their health insurance because of bureaucratic red tape.

CMS has taken steps to try to mitigate harm cause by Medicaid Unwinding. In June 2023, CMS provided a list of flexibilities and approaches available to states to help minimize procedural coverage terminations. Additionally, on August 9, 2023, CMS sent letters to all state Medicaid agencies detailing the actions required to fix high call center wait times, excessive procedural terminations, and lengthy processing of financial eligibility forms. Patient organizations, including NBDF and HFA, have called on CMS to release monthly data on Medicaid Unwinding more quickly, release detailed information about enforcement, and to fully utilize enforcement authority as passed by Congress.

HTC patients will be impacted by Medicaid Unwinding. To assist your patients with this process and ensure they maintain Medicaid coverage, please review the newly updated toolkit for providers released by the Hemophilia Federation of American and the National Hemophilia Foundation.

If your patients are experiencing challenges with Medicaid Unwinding or for additional information and strategies to address the Medicaid Unwinding process in your state, reach out to your primary contact with the Hemophilia Alliance who can connect you with the team members working on this issue.