US Asks 9 States To Cut Child Medicaid, CHIP Disenrollments


In a recent move, the Biden administration is asking states that have gone on to drop the largest numbers of children out of their Medicaid as well as Children Health Insurance Program rolls to take up the federal flexibilities so as to prevent them from losing coverage when it comes to healthcare.

These nine states include Texas, New Hampshire, Arkansas, Montana, Georgia, Florida, Ohio, South Dakota, and Idaho, which account for almost 60% of the dip in children’s Medicaid along with CHIP enrollment from March through September, as per the data released by the CMS on December 18.

Xavier Becerra, the HHS Secretary, asked the states to embrace federal flexibilities as well as strategies so as to ease renewal, eliminate CHIP enrollment fees and premiums, decrease call center wait times, partner with local organizations, as well as expand Medicaid.

It is well to be noted that the state Medicaid programs started reassessing eligibility for the safety-net insurance program in spring post a continuous enrolment that took place during the course of the COVID-19 pandemic. Consistent enrollment provisions went on to cause rolls to nearly swell up to almost 94 million people, and that’s just when the unwinding began in March 2023.

Enrolment still happens to be elevated vis-à-vis the pre-pandemic period, as more than 88 million people were insured under Medicaid and CHIP in September, compared to around 71 million enrolled in February 2020.

But federal regulators have gone on to grow very concerned when it comes to the procedural disenrollments in which the beneficiaries get removed because of administrative reasons but could still be eligible for coverage. They have also gone on to crack down on states for the coverage losses among children, who happen to have a lower bar to stay within the programs in terms of low-income people.

Earlier in December, the CMS went on to publish an interim final rule that could go on to have fines or even slash funding to states if they do not follow federal requirements throughout the redeterminations process.

Regulators also went on to pause the procedural disenrollments across 30 states this fall because of a system issue with automatic renewals. States were doing checks at a family level and also eliminating beneficiaries, like kids, who may still be eligible.

Chiquita Brooks-LaSure, CMS Administrator, said that the CMS is doing everything in its gamut and power to safeguard access to health coverage throughout the Medicaid and CHIP renewal processes, particularly for children. As a matter of fact, many states have worked with them to embrace the strategies they have gone on to put on the table, and they strongly ask all states to play their respective parts to make sure that children who are eligible have the coverage they need so as to grow and thrive.

In its entirety, child enrollment when it comes to Medicaid and CHIP has dipped by 2.2 million from March through September, as per the latest data from the CMS.

But there does happen to be a significant variation by state, as five states make up over half of the total dip in child enrollment. South Dakota, along with Idaho, both saw a 27% reduction in child enrollment during the said period.

Interestingly, the regulators noted that the dearth of expansion of Medicaid was one common thread in the states having high numbers of child disenrollments. The 10 holdout states, like Alabama, Kansas, Mississippi, Florida, Georgia, Tennessee, Texas, Wisconsin, South Carolina, and Wyoming, happen to remove more children than all the expansion states put together, as per the CMS.

Notably, the youngsters who turned 19 during the continuous enrollment period were also likely to be disenrolled in case of non-expansion states. Apparently, the states that are more frequently used to go for auto-renewals, in which the programs determine the eligibility by way of the available data, went on to disenroll fewer children too, said the CMS.