Between 5.3 and 14.2 million people will lose their Medicaid coverage when the COVID-19 public health emergency (PHE) ends. That’s the sobering finding of a new Kaiser Family Foundation (KFF) report analyzing what states will do when the temporary eligibility rules adopted during the PHE end.
Explanation: The Families First Coronavirus Response Act (FFCRA) adopted in the early days of the PHE provided for a 6.2 percent increase in the federal Medicaid match rate (Federal Medical Assistance Percentage, or FMAP) for states that met “maintenance of eligibility” (MOE) criteria designed to broaden who could qualify for Medicaid and keep them continuously enrolled during the PHE. Those MOE incentives will expire at the end of whatever month the PHE ends. That could be as soon as July 31, 2022, if the PHE isn’t extended by July 15. Under that scenario, the continuous enrollment requirement would end on August 1 and the enhanced FMAP spigot would be turned off at the end of the fiscal third quarter on Sept. 30.
The KFF analysis considers what impact these events will have on Medicaid enrollment. The report projects that the significant growth in Medicaid enrollment that began in 2019 will continue through the end of 2022. That would represent total growth of 25 percent or 22.2 million enrollees over the period, of which 18.7 million would be attributable to MOE continuous enrollment requirements. But once those requirements disappear, enrollment is likely to decrease significantly at rates varying from state to state. Where total losses fall within the 5.3 to 14.2 million range will depend on how states handle eligibility redetermination and disenrollment. KFF expects that Affordable Care Act expansion adults, other adults such as parents not eligible based on a disability, and children will be the hardest hit.