23% of disenrolled Medicaid beneficiaries remain uninsured, KFF finds

Nearly one in four people who were disenrolled from Medicaid remain uninsured, citing costs as barriers to coverage, according to a KFF poll.

Since states resumed conducting Medicaid eligibility determinations in April 2023, more than 20 million beneficiaries have been disenrolled. KFF surveyed 1,227 adults who had Medicaid coverage prior to April 1, 2023, to assess their experience with the unwinding process and how losing coverage has affected their finances and health.

One in five (19 percent) of beneficiaries said they have lost Medicaid coverage at some point since April 1, 2023. Adults under 50 and those who experienced problems during the renewal process were more likely to be disenrolled.

Around half of those who were disenrolled last year have re-enrolled in Medicaid coverage, 16 percent have employer-sponsored insurance, 9 percent have Medicare coverage, and 8 percent have purchased coverage on the Affordable Care Act (ACA) marketplace. Twenty-three percent of adults who were disenrolled are currently uninsured.

Among uninsured respondents, 54 percent said they have not enrolled in another form of health insurance due to costs. Some said they are still trying to get Medicaid coverage, are not aware of other insurance options, or have been too busy to find alternate coverage.

Adults who transitioned to a new form of coverage said their plan is better than Medicaid when it comes to care access, but out-of-pocket costs and monthly premiums are higher.

At the time of disenrollment, 70 percent said they became uninsured, while 30 percent had another form of healthcare coverage in place. Three-quarters of those who became uninsured reported worries about their physical health and 60 percent said they were worried about their mental health after losing coverage.

Additionally, 56 percent of adults who lost Medicaid coverage at some point reported skipping or delaying needed healthcare services or prescription medication when attempting to renew their coverage.

The outcome of Medicaid redeterminations largely depended on the beneficiary’s experience during the renewal process.

Among adults enrolled in Medicaid before the unwinding period began, 29 percent said they do not remember receiving information about renewing their coverage. The 70 percent of beneficiaries who recalled receiving information were more likely to take action to renew coverage.

Nearly 60 percent of beneficiaries who took action to renew their coverage experienced at least one problem during the process, such as long wait times on the phone and a lack of knowledge about the documents needed for renewal.

Around three-quarters of beneficiaries trying to renew their Medicaid coverage said they were asked to submit proof of income or financial assets, while 54 percent were asked to submit proof of residency in their state.

Individuals living in states that have not expanded Medicaid were at least 20 percentage points more likely than those in Medicaid expansion states to say they were asked to submit proof of residency. Black (71 percent) and Hispanic (60 percent) adults were also more likely to be asked to submit proof of residency than their White counterparts (42 percent).

A significant number of disenrollments from Medicaid have been due to procedural reasons, indicating that better communication between states and beneficiaries may help avoid coverage losses.