Millions of Americans are on the verge of losing their Medicaid coverage, posing a significant threat to one of President Joe Biden’s key health care achievements. This rollback comes at a highly inconvenient time as states from both sides of the political spectrum have been dropping low-income individuals from Medicaid programs, marking the first significant purge in three years. The end of a pandemic policy designed to prevent sudden loss of health coverage for vulnerable populations has intensified this situation. Despite efforts to rectify errors and minimize coverage losses, nearly 4 million Americans have already been affected, primarily due to paperwork issues. Experts fear that this number could skyrocket to 15 million within a year, potentially higher.
This wave of coverage reductions is a notable reconfiguration of the health insurance landscape since the implementation of Obamacare. It coincides with a resurgence of Covid cases and Biden’s bid for re-election, where he aims to persuade working-class voters that his policies have positively impacted their lives. However, the ongoing loss of coverage threatens to undermine the progress that the White House celebrated in terms of health coverage and poverty reduction. Biden’s supporters worry that the timing of these rollbacks will weaken his central message that his policies are benefiting the most vulnerable.
Joan Alker, the executive director of Georgetown University’s Center for Children and Families, has described this situation as an “unprecedented” one that may result in an increase in the uninsured rate. The root of the problem lies in a congressional decision made in early 2020 to suspend the annual renewal requirement for Medicaid enrollees, ensuring continuous coverage throughout the pandemic. This led to a record number of 93 million people being covered by Medicaid, with one in four Americans benefitting from the program. However, when Congress removed this protection in April before the Covid public health emergency concluded, states began reviewing their Medicaid rolls to identify individuals who were no longer eligible due to increased income or changes in circumstances such as pregnancy or parenting status. The consequences have been drastic, with Florida removing over 400,000 individuals from Medicaid in just three months, and Texas terminating coverage for over half a million people in a single month due to paperwork issues. Even Democratic-led states like Kansas and Kentucky are witnessing significant drops in Medicaid enrollment.
The Biden administration claims to be actively pressuring states to rectify errors and minimize coverage losses. While they highlight the impact of their efforts, they have refrained from publicly criticizing specific states to maintain positive relationships. Although Democrats have an advantage on health issues in polls and Biden’s expansion of Obamacare subsidies may assist some individuals transitioning from Medicaid, the coverage losses could create skepticism among voters about the government’s efficacy during difficult economic times.
Jamila Michener, co-director of the Cornell Center for Health Equity, has noted that past instances of Medicaid coverage loss have been linked to decreased voter turnout. This potential decrease in engagement could have electoral consequences, particularly in areas where disenrollment alienates Medicaid beneficiaries from politics and the electoral system.