What the Medicaid Undercount Reveals About the Medicaid ‘Unwinding’

Census surveys suggest continuous enrollment policy kept millions unknowingly on Medicaid even after they moved on to other coverage

Preview:

What the Medicaid Undercount Reveals About the Medicaid ‘Unwinding’ exposes how federal policies implemented during the pandemic kept millions of people enrolled in Medicaid even after they gained other coverage through a new job or aged into Medicare. The report documents how millions who moved to new coverage were not even aware they were still enrolled in the federal program. As a result, billions of dollars in Medicaid premiums were billed and collected by Medicaid managed care organizations (MCOs), even though many of their enrollees had moved on to other coverage. Medicaid is the federal government’s health care program for people with low income, administered by states.

When the pandemic hit in March of 2020, the federal government gave states additional Medicaid funding on the condition they maintained continuous enrollment throughout the pandemic. Even if someone had a life event that made them no longer eligible for Medicaid, they were required to remain enrolled by the state. States began “unwinding” Medicaid enrollees by verifying their eligibility for the program when this “continuous enrollment condition” finally ended on April 1, 2023.

American Experiment’s review of data from the U.S. Census Bureau and the State Health Access Data Assistance Center (SHADAC) at the University of Minnesota shows how this federal policy kept millions of people unknowingly enrolled, which allowed Medicaid premiums to continue to be billed and collected in their name.

A full copy of the report can be viewed here.