Medicaid Unwinding: 25M+ Disenrolled, Renewal Rates & State Data (Sept 2024)

The unwinding of the continuous enrollment provision in Medicaid and the Children’s Health Insurance Program (CHIP) has resulted in significant shifts in coverage across the United States. As of September 12, 2024, data indicates that over 25 million people have been disenrolled, representing 31% of those with completed renewals, while over 56 million have had their coverage renewed – 69% of completed renewals. This process, largely completed as of this date, reveals substantial variation in outcomes from state to state.

Medicaid Enrollment Shifts

Disenrollment rates have varied considerably, ranging from a high of 57% in Montana to a low of 12% in North Carolina. These differences are linked to varying state policies, renewal procedures, and, in some cases, expansions of eligibility criteria. North Carolina and South Dakota, for example, adopted Medicaid expansion during this period, potentially contributing to lower disenrollment rates.

Did You Know? States are required to first attempt to renew coverage administratively, using existing data sources, before requesting information from enrollees.

A significant portion of those disenrolled – nearly 70% – lost coverage for procedural reasons, such as incomplete paperwork or outdated contact information. This suggests that many individuals who were disenrolled may still have been eligible for coverage. Conversely, approximately 31% were determined ineligible for Medicaid.

Automated Renewals

The renewal process wasn’t uniform across the country. Over 61% of those whose coverage was renewed did so automatically, through an “ex parte” process. This means their eligibility was verified using existing data without requiring them to take any action. Ex parte renewal rates varied significantly, from over 90% in Arizona, North Carolina, and Rhode Island, to less than 20% in Pennsylvania and Texas.

Expert Insight: The high rate of procedural disenrollments raises concerns about access to care for vulnerable populations. Streamlining renewal processes and ensuring accurate contact information are critical to maintaining coverage for those who remain eligible.

Data used to assess these trends comes primarily from monthly reports submitted by states to the Centers for Medicare & Medicaid Services (CMS). In some cases, data from state websites were used to provide more complete or timely information.

Looking Ahead

As the unwinding period concludes, states will likely focus on assessing the impact of these changes on overall healthcare access. It is possible that states with high disenrollment rates may see an increase in uninsured individuals, potentially straining local healthcare systems. Analysts expect ongoing monitoring of enrollment trends to identify any disparities and inform future policy decisions. A possible next step for states could be targeted outreach efforts to re-enroll individuals who were disenrolled for procedural reasons but remain eligible.

Frequently Asked Questions

What percentage of people with completed renewals were disenrolled as of September 12, 2024?

31% of people with completed renewals were disenrolled as of September 12, 2024.

What was the primary reason people were disenrolled from Medicaid?

Nearly seven in ten (69%) of those disenrolled had their coverage terminated for procedural reasons.

How were most renewals completed?

61% of renewals were completed on an ex parte, or automated, basis, meaning the individual did not have to take any action to maintain coverage.

How might these changes in Medicaid enrollment impact access to healthcare in your community?