The end of the Medicaid scheme has hit more Black and Hispanic Americans, a new study found.
During the COVID-19 pandemic, health insurance coverage improved significantly for millions of Americans through Medicaid enrollment.
However, as the emergency ended in April 2023, around 10 million people lost their Medicaid coverage as states began re-evaluating eligibility.
Notably, three-quarters of these disenrollments occurred due to procedural issues rather than ineligibility. These issues often involved enrollees not receiving renewal notices, failing to submit the correct paperwork, or not completing all the required steps for Medicaid redetermination.
And now new research suggests that Black and Hispanic citizens were disproportionately affected by the disenrollments.
A study published in JAMA Internal Medicine by researchers from Oregon Health & Science University (OHSU), Northwestern University, and Harvard Medical School found that Black and Hispanic people were twice as likely as white people to lose Medicaid coverage due to administrative problems.
"A lot of people got kicked off Medicaid for administrative reasons," Jane Zhu, an associate professor of medicine at OHSU and the study's senior author, said in a statement "Our study found that Black and Hispanic people are twice as likely to lose Medicaid insurance for reasons that can be addressed by systems improvements."
State-level data on the causes of these disenrollments is not very widespread, with only nine states currently reporting disenrollments by race and ethnicity, the authors note. To overcome this, they used data that was publicly available from the U.S. Census Bureau's Household Pulse Survey, conducted between March 29 and October 2, 2023, to estimate adult Medicaid disenrollment by race and ethnicity during the Medicaid unwinding period. The findings revealed that individuals identifying as Black and Hispanic were twice as likely as white people to report losing Medicaid coverage due to difficulties in completing the renewal process
The study authors are now calling for policymakers to enhance Medicaid enrollment processes to address health disparities. Recommendations include transparent reporting of race and ethnicity data, streamlined administrative procedures, expanded renewal assistance, and prioritized redeterminations for beneficiaries most likely to be ineligible.
"Addressing these barriers may include more transparent race and ethnicity data reporting, expedited administrative processes, expanded renewal assistance, and prioritized redeterminations for beneficiaries most likely to be ineligible," the researchers wrote.
The expiration of continuous coverage protections has led to significant disenrollments, with estimates suggesting that up to 18 million people could lose Medicaid coverage by May 2024. Many of these individuals, despite being eligible, fall through the cracks due to administrative hurdles, particularly those who may face language barriers and other systemic issues.
This work highlights the need for systemic improvements to prevent disproportionate impacts on vulnerable populations during Medicaid redetermination processes, the authors wrote.
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