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Updated: Alarming data for disenrolled Medicaid recipients has been released. What do these numbers mean for healthcare providers and their staff?

Updated Article: June 2024

By: Francisco Francisco, Medicaid Eligibility Supervisor

Recent reports, including one from the Congressional Budget Representational Office (CBO) published in the Journal Health Affairs, have highlighted concerning trends about the uninsured rate in the United States. The uninsured rate currently stands at 7.7%, with 26 million individuals lacking coverage, an increase from an all-time low of 7.2% in 2023. The CBO projects this rate to rise to 8.9% by 2034 due to several factors such as:

  • Ending of enhanced subsidies for health insurance marketplace plans in 2025
  • Increase in uninsured rate due to increased immigration

Immigrants tend to be uninsured at higher rates than the general population. While many obtain coverage through employer-sponsored plans, those legally residing in the United States and qualifying for federal health programs have restricted access.

These disenrollments, a significant challenge, often occur because patients no longer meet Medicaid's qualifications due to changes in income or familial status. This leads to an increase in patients needing assistance with Medicaid reenrollment or finding health insurance through the marketplace, a situation that healthcare providers must be prepared to handle.

To handle this influx, it is essential for healthcare providers to employ capable and experienced staff who can assist these new groups of disenrolled patients every month. Unprepared providers might be overwhelmed by these continuous waves of patients needing help with reenrollment processes.

Preliminary data from April 2023 across eighteen states revealed by the Centers for Medicare & Medicaid Services (CMS) indicated that 31% of Medicaid or CHIP renewals resulted in coverage loss. Alarmingly, 79% of these losses were due to procedural issues such as the failure to return a renewal form.

In response to these challenges, CBIZ offers the Virtual Eligibility Counselor (VEC) as part of its Medicaid Eligibility suite. This service is a game-changer, allowing hospitals to expand their reach to patients by guiding them through the Medicaid renewal process virtually. VEC has significantly enhanced the reenrollment effectiveness for our clients, ensuring higher compliance rates among patients. VEC can either be a standalone service for those outsourcing Medicaid eligibility or to help with hard-to-reach patients, such as out-of-state Medicaid eligibility.

Contact our office today at 800.957.6900 or [email protected] to learn more about our Medicaid Eligibility Services.

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