Following the end of the Medicaid continuous enrollment provision, more than 1.5 million Medicaid enrollees have been disenrolled from coverage as of June 29, according to a recent report that analyzed the most current data from 27 states and the District of Columbia.

The KFF report was first published May 3 and was updated June 29. It pulled data from state websites and the Centers for Medicare and Medicaid Services.

The continuous enrollment provision barred states from disenrolling Medicaid members during the Covid-19 public health emergency. However, this provision ended March 31, allowing states to resume Medicaid redeterminations, the process for determining if enrollees are still eligible for Medicaid. States are starting the disenrollment process at different times: five states started in April, 14 states started in May, 22 states started in June, 9 states are starting in July and one state will start in October.

The report found that 38% of people with a completed renewal were disenrolled in the reporting states. About 62%, or 2.6 million enrollees, had their coverage renewed. However, “because not all states have publicly available data on total disenrollments, the data reported here undercount the actual number of disenrollments.”

KFF also found that disenrollment rates vary widely by state. Disenrollments range from 75% as a share of total completed renewals in South Carolina to 16% as a share of total completed renewals in Virginia. These differences are largely due to “who states are targeting with early renewals” and differences in their renewal policies, the researchers stated.

“Some states (such as South Carolina) are initially targeting people early in the unwinding period that they think are no longer eligible or who did not respond to renewal requests during the pandemic, but other states are conducting renewals based on an individual’s renewal date,” KFF said. “Additionally, some states have adopted several policies that promote continued coverage among those who remain eligible and have automated eligibility systems that can more easily and accurately process renewals while other states have adopted fewer of these policies and have more manually-driven systems.”

In the states with available data, about 71% of those who were disenrolled from Medicaid were disenrolled for procedural reasons, like not updating contact information or not completing renewal packets within a certain timeframe. 

When examining procedural disenrollments by state, there is also wide variation. In South Carolina, 93% of total disenrollments were procedural. In Arkansas, meanwhile, 15% of disenrollments were procedural.

“High procedural disenrollment rates are concerning because many people who are disenrolled for these paperwork reasons may still be eligible for Medicaid coverage,” KFF said.

There is limited data on disenrollment rates of children, with only five states reporting those numbers: Arkansas, Arizona, Indiana, Virginia and Oklahoma. But in those five states, children represented more than a third of Medicaid disenrollments. At least 156,000 children were disenrolled out of 425,000 total disenrollments in the five states. In Arkansas, children accounted for 39% of total disenrollments, while they accounted for 32% in Oklahoma.

Up to 18 million people could lose coverage during the return to Medicaid redeterminations, the Urban Institute predicts. Of that group, about 21.2% will become uninsured, according to an analysis by NORC at the University of Chicago.

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