Over the past three years, policy changes in Medicaid and expanded subsidies in the health insurance marketplace have led to dramatic expansions in health coverage and the lowest-ever uninsured rate. Roughly 9.3 million people who were not previously covered obtained coverage during this period. More than 89 million people are now enrolled in Medicaid or the Children’s Health Insurance Program (CHIP), and an estimated 14.5 million people are enrolled in marketplace coverage.
The United States generally has poor access to health care, largely because it is so expensive. While this is a problem for both insured and uninsured people, surveys show health care affordability is much worse for people without health insurance coverage. Families USA examined the impact of the coverage gains of 2020-2022 on health care financial access. To understand the possible effects of these coverage expansions, Families USA looked at data from a survey that asked participants the extent to which health care and medicines were accessible. The Centers for Disease Control and Prevention (CDC) data shows fewer people reporting financial barriers to accessing care than ever before. Specifically, the proportion of people reporting that they delayed seeking medical care or were not taking medications as prescribed because of cost declined significantly between 2019 and 2021. Additionally, the racial disparities among those delaying needed care due to cost also declined dramatically.
However, these gains are at risk. When the COVID-19 public health emergency ends, states will resume the process of redetermining Medicaid enrollees’ eligibility. As states take on the monumental task of resuming processes to make sure everyone currently receiving Medicaid is eligible, millions of qualified enrollees, including millions of children, could lose coverage due to administrative errors and other paperwork barriers.
Congress must ensure that redetermination processes are clear and consistent for families to demonstrate their continued eligibility and create a smooth pathway to help those no longer eligible for Medicaid transition to a new source of coverage.