Many children may have lost Medicaid coverage due to state errors

Federal officials have warned state agencies to review their systems for establishing eligibility as they reduce Medicaid lists . Children in particular may have been affected.

Federal officials have discovered major errors in the systems and procedures that some states use to verify Medicaid eligibility, which could lead to the loss of a large number of children despite their health coverage. still eligible.

State agencies 'unwound' a pandemic-era policy that allowed people to retain health insurance coverage through Medicaid, l joint federal-state agency. program for low-income Americans without regular eligibility checks.

After that rule expired in April, at least a million children lost their coverage, the researchers found, despite having considerably higher eligibility limits than adults.

In a letter to Medicaid agencies in State, Daniel Tsai, a senior official with the Centers for Medicare and Medicaid Services, warned that technical errors could be responsible for many unenrollments.

Mr. Tsai told reporters during a Wednesday press briefing that the issue was "a very specific system issue that we believe has huge implications for eligible children and families who maintain coverage." »

Many states perform what are called "ex parte" renewals, or automatic checks that rely on databases, such as State wage records, to determine if individuals are still eligible for Medicaid coverage.

States are required to verify eligibility of beneficiaries individually. But after proceeding with automatic renewals, some states appear to have sent out renewal forms requesting information on all household members and unenrolled everyone if the forms are not returned, including those who should have been deemed eligible via the ex parte process, Mr. Tsai said. wrote in the letter.

Children may have been disproportionately punished by the practice, officials said Wednesday.

The administration has ordered states that identified this error to correct their eligibility systems, suspend removals, and reinstate those affected by the errors.

The letter amounted to one of the most divisive actions taken by federal officials since the start of the unraveling, which led to the loss of coverage of more than 5.5 million people, according to state data analyzed by KFF, a health policy research organization.

Mr. Tsai declined to disclose the states in which authorities discovered the problem, but said state agencies had two weeks to verify the problem and report it to the federal government.

A spokesperson for Mr. Tsai's agency later said that more than a dozen states believed to be affected.

Since the onset of the pandemic until early April, states were not allowed to opt out. people do not receive Medicaid under a provision of a 2020 Congressional coronavirus relief package.

That law, which offered federal funding additional to the states, increased program enrollment to record highs. At the start of this year, 93 million people were enrolled in Medicaid or the Children's Health Insurance Program, up from 71 million before the pandemic.

University Center researchers of Georgetown for Children and Families estimated before the start of the dénouement that