The rate of Hoosiers who lost Medicaid coverage dropped in June but roughly one-third of those were children. Photo from Getty Images.

By Whitney Downard
Indiana Capital Chronicle

INDIANA — The number of Hoosiers who lost Medicaid coverage due to an “unwinding” of COVID-19 protections decreased significantly in June, totaling 35,595.

In comparison, 52,985 Hoosiers fell off of the Medicaid rolls in April followed by another 53,684 the next month, according to monthly reports from the Centers for Medicare and Medicaid Services.

Combined, Medicaid shed 142,264 Hoosiers over the first three months of a yearlong process that stakeholders initially estimated would total between 300,000-400,000.

Nationwide, millions of people have lost their insurance under a process to undo “continuous coverage” from the pandemic, under which the federal government incentivized states to keep everyone on the Medicaid rolls regardless of their eligibility. Following the expiration of the Public Health Emergency earlier this year, nearly every state has started the process of reviewing enrollees to determine whether they still qualify.

Hoosiers with Medicaid needing to renew in the next year should visit the Family and Social Services Administration (FSSA) website to check their information and learn more.

June Specifics

Fewer Hoosiers overall lost coverage in June, including 4,844 who were deemed ineligible and transferred to the health care marketplace. The remaining 30,751 were booted for procedural reasons, such as not finishing their paperwork — a major source of criticism in recent months.

Across the three months, 86% of Hoosiers lost coverage due to procedural reasons — higher than the national average of 74%, as calculated by KFF, a nonprofit dedicated to health care policy.

ndiana’s 86% disenrollment rate for procedural reasons exceeds the national average of 75%. Chart from KFF.

“Procedural disenrollments … can occur when the state has outdated contact information or because the enrollee does not understand or otherwise does not complete renewal packets within a specific timeframe,” KFF’s Medicaid Unwinding dashboard explains. “High procedural disenrollment rates are concerning because many people who are disenrolled for these paperwork reasons may still be eligible for Medicaid.”

FSSA notes that Hoosiers can reapply and even get retroactive coverage up to 90 days after falling off of the rolls, unless they have covered under the Healthy Indiana Plan.

In the June report, the state added an explanation for procedural disenrollments, saying that one-third, or 10,440, of those dropped for procedural reasons were Hoosiers who were over income, had moved outside of the state or died.

A May report indicates that 27% of those eligible for renewal that month lost coverage due to procedural reasons. The bulk of those, 14%, were Hoosiers who didn’t respond to FSSA’s inquiries followed by another 9% who didn’t respond but were still found to be ineligible.

Just 4% had incomplete applications or fell off of the roles due to death, out-of-state moves or voluntary withdrawals. But the agency notes that over one-third of those who lost coverage due to procedural reasons “were known to have other coverage.”

More Information Still Forthcoming

Data about the impact of lost coverage remains incomplete, though some preliminary details indicate that many of those falling off of the rolls are children, who made up more than one-third of disenrollments.

KFF, the health care nonprofit, reported just seven states with detailed breakdowns of disenrollments for May, of which children make up 31% — slightly lower than Indiana’s rate.

However, Indiana was among one of the earlier states to start the process, ahead of 32 other states.

Every state but Oregon — which delayed their review to October — conducted reviews in July, meaning that state averages will change as larger states join. Within the 35 states (and Washington D.C.) that analyzed Medicaid rolls in June, 3.3 million lost coverage, primarily in Texas and Florida.

In terms of total numbers, Indiana still ranks in the top 8 but fell to 18 when it came to the rate of disenrollments, according to KFF.

Additionally, Indiana doesn’t yet include data about the combined number of Hoosiers who fell off of the rolls and how many were able to re-apply for coverage. Reports for May and April indicate that white, non-Hispanic Hoosiers and those between the ages of 19 and 64 made up the bulk of losses. That demographic information is not yet available for June.