Topline
The U.S. Department of Health and Human Services announced Thursday nearly 500,000 children and families were wrongly disenrolled from Medicaid and Children’s Health Insurance coverage because of a “systems issue” and will have their coverage reinstated, though it is unclear how long the process will take.
Children were among the people removed from coverage. (Photo by John Moore/Getty Images)
Key Facts
The systems issue, which was reported by the Centers for Medicare & Medicaid Services to all states on August 30, disenrolled children and other insurance holders from Medicaid even though the states had information confirming eligibility.
Thirty states in total suffered from the issue and were required by CMS to pause procedural disenrollments for those impacted unless “they could ensure all eligible people are not improperly disenrolled due to this issue,” according to a CMS statement.
The states were wrongly conducting Medicaid eligibility at the family level instead of on an individual basis, making thousands of people including children ineligible for Medicaid, according to Politico.
The impact of the systems issue varies widely between states, according to a Medicaid report, with many continuing to sort out the problem.
What We Don’t Know
CMS did not make clear when reinstatement will be secured for all of the impacted people, which may be hard to predict given the differences of the issue’s impact in each of the 30 states.
Big Number
93.8 million. That’s how many people were enrolled in Medicaid and CHIP in the 50 states and the District of Columbia as of May.
Key Background
All states are currently in a Medicaid eligibility review process following the March expiration of a pandemic-era rule that kept people enrolled in the low-income health insurance program even if they didn’t meet coverage requirements. States typically use computer programs to determine automatic re-enrollment into Medicaid. However, states will contact people via mail, email or phone if more information is needed to determine re-enrollment or eligibility. Last month, CMS warned of a “glitch” in the automated systems used in the eligibility review process, according to the Associated Press. The glitch dropped entire families from coverage when nobody responded instead of evaluating on an individual basis.
Further Reading
Medicaid coverage restored to about a half-million people after computer errors in many states (AP)
Half a million people, including kids, mistakenly dropped from Medicaid (Politico)
