Lewis & Ellis, LLC

Medicaid projected for surge in enrollment

Health Care and Health Insurance
by Jacqueline Lee
Special ACA enrollment period seeing early success
Special ACA enrollment period seeing early success

Tens of millions of people across the country have lost their jobs since the onset of the novel coronavirus pandemic, which likely also resulted in losing their health insurance coverage. Fortunately, there are numerous safety nets in place to help people find options to keep their health care affordable, but the rush of sign-ups could put some stress on even those systems.

Between state-run Medicaid and child health care services, it's likely that sign-ups will surge as people try to avoid a potentially worrisome coverage gap, growing enrollment appreciably, according to Colorado Public Radio. Now, some states are keeping closer tabs on what this might mean for them, as the surge is being driven in large part by declining employment. That, of course, is an unavoidable issue that may not be alleviated any time soon.

A separate issue
However, the numbers are also being propped up by the fact that the federal government declared a health emergency that restricted states from removing people from Medicaid for failing to meet eligibility requirements, CPR noted. In Colorado, for instance, some 300,000 of the state's current Medicaid enrollees would typically have been removed from the program's rolls for a number of reasons, but are required to be kept on until the federal health emergency comes to an end. It is difficult to project when that will happen. As such, likely millions or more will once again be forced to go without coverage (at least temporarily) once the emergency status is lifted.

Nationally, it's believed that about 25.4 million workers will lose employer-sponsored coverage throughout the pandemic, according to a Robert Wood Johnson Foundation study conducted by the Urban Institute. Of that, nearly half would enroll in Medicaid, and a quarter would sign up for new coverage via the state or federal insurance exchanges. Almost 30% would simply end up being uninsured.

Medicaid enrollment is will grow considerably nationwide.Medicaid enrollment will likely grow considerably nationwide.

A big hurdle
Of course, not all states have been as aggressive in expanding their Medicaid programs in recent years, which is another issue for Medicaid enrollment. For instance, in states where programs expanded, more than half would become Medicaid-eligible, and fewer than 1 in 4 would simply become uninsured. But in states that did not expand, only about 1 in 3 will likely end up on Medicaid, and 40% would go without coverage.

That, in turn, could present a major problem for states trying to bear the financial burden of broadening enrollment, even after a round of federal dollar-matching was intended to buoy those state-level programs. Experts believe more can be done in this area, however, as well as waiting for state governments to find their own solutions.

A look at the landscape
This surge of people who previously had employer-sponsored coverage onto state Medicaid programs may also fundamentally shift demographics for the programs. The Kaiser Family Foundation notes that the vast majority of people covered by Medicaid before the pandemic were actively working - at least part-time - or "faced barriers" to doing so, and tended to work in sectors that exposed them to greater risk of coronavirus infection. In all, another 1 in 3 adults covered by the program only working part-time due to a lack of available childcare or their employers not being able to provide enough hours for them to qualify as full-time workers.

Moreover, all those issues typically result in financial insecurity that is only likely to get worse amid a broad - potentially global - economic downturn.

Other considerations
Meanwhile, the long-term care industry is also likely to be rocked by these conditions, according to Provider. For many, the majority of their residents are covered by Medicaid or, less often, Medicare as well as other programs (federal and otherwise) to alleviate the cost burden on residents. It's not uncommon for care providers to see significantly different Medicaid reimbursement rates on a state-by-state basis, and for that reason some simply do not deal with the financial and administrative issues that come with treating Medicaid patients. Even those that do - especially if they are part of larger operations - may need to scale back certain aspects of their operations to help make ends meet.

All of these factors likely limit the quality and availability of care for Medicaid enrollees, which could also be further strained by the fact that so many are signing up for coverage. As a consequence, legislators, care providers, insurers and beyond may need to do more to find solutions that will help all involved - including patients - find the best possible outcomes at a time when hardly anything is ideal. These kinds of solutions could be literal life-savers for millions of Americans, and time may be of the essence when it comes to taking the all-important next step toward better conditions for Medicaid writ large.



Consultants to Contact