A combination of factors, including a slowdown resulting from a pandemic, has led to a record number of Americans seeking government medical coverage.
A photo published by the The Centers for Medicare & Medicaid Services revealed last week that more than 80 million Americans have health coverage through Medicaid and the Children’s Health Insurance Program, the highest on record.
“Medicaid is a counter-cyclical program, which means enrollments typically increase during a downturn as more people qualify and need Medicaid,” Cindy Mann, partner at Manatt Health said in an email. .
Unsurprisingly, CMS data shows nearly 9.9 million people signed up for coverage between February 2020 and January of this year.
The demographics of registrants have also changed due to the recession. It is typically children, the elderly, the blind and disabled who make up the lion’s share of Medicaid registrants, Adam Striar, senior director of Manatt Health, said in an email.
But this time around, enrollment increases were seen among adults without children, parents and pregnant women, “reflecting considerable volatility in the labor market and many working-age adults losing their earnings and losing their earnings. access to employer sponsored coverage, ”he said.
However, widespread unemployment was not the only driver of the increase in registrations. There was also the federal requirement that states could not remove people from the Medicaid program during the public health emergency, if the state had agreed to accept additional matching funds from Medicaid, she said.
In general, the costs incurred by states to administer Medicaid are offset by the federal government at a rate of 50%, according to a Kaiser Family Foundation Report. As states struggled financially during the pandemic, the government allowed a 6.2 percentage point increase in the federal match rate for states that meet certain criteria, including the above Medicaid requirement.
CMS itself has acknowledged that registrations have increased due to this requirement, which has led states to suspend their regular eligibility checks and opt-out activities, said Yulan Egan, chief executive of the advisory board, in an email.
“In other words, Medicaid enrollment has increased not only because of an increased number of people entering the program, but because the flow of people out of the program has essentially been interrupted,” Egan said.
Medicaid enrollment is expected to continue, a key indicator being that enrollment has not slowed significantly in recent months, even as the economy has started to recover, said Adam Striar, senior director of Manatt Health, in an email.
“Many states continue to see enrollments increase by 1% or more each month, which is significantly faster than the typical growth before the pandemic,” he said. “This pattern is not atypical in times of recession; there is often a long “queue” for signup wins.
Overall, this increase in enrollments has taken some relief from the healthcare industry, Egan of the advisory board said. For health plans, growth in Medicaid enrollments helped offset losses in business enrollments, while for providers, the increase was better for their finances than an increase in the uninsured.
But once the public health emergency is declared over, states and payers will need to prepare for a massive eligibility determination process. Many people may have changed addresses, some may have lost their homes, and most did not have to contact their Medicaid agency during the pandemic, said Mann of Manatt Health.
“[States will need to] associate with plans, suppliers [and] community groups to prevent eligible people from losing coverage, ”she said.
Photo: zimmytws, Getty Images