What's Happening?
A recent analysis by the Urban Institute and the Robert Wood Johnson Foundation forecasts that between 5 million and 10 million individuals could lose Medicaid coverage by 2028. This potential loss is attributed to the implementation of new work requirements
and more frequent eligibility checks, as mandated by last year's reconciliation law, known as the 'Big Beautiful Bill.' The study highlights that the shift to six-monthly eligibility checks could result in 2.0 to 3.1 million people losing coverage, while work-reporting mandates could lead to 3.0 to 7.0 million losing Medicaid. Notably, many of these losses are expected to occur due to documentation and verification issues rather than a failure to meet work requirements. The analysis also points out that certain groups, such as self-employed individuals and those living with family members with disabilities, are at a higher risk of losing coverage.
Why It's Important?
The potential loss of Medicaid coverage for millions could have significant implications for the U.S. healthcare system and economy. If a large number of individuals lose coverage, hospitals and employers may face increased costs due to a rise in uncompensated care and a potential decline in workforce health and productivity. The study underscores the importance of administrative design in mitigating these losses, suggesting that states with stronger data matching and broader exemption definitions could substantially reduce the number of people losing coverage. This situation presents a critical challenge for policymakers, employers, and benefits administrators, as they must navigate the complexities of implementing these changes while minimizing negative impacts on vulnerable populations.
What's Next?
As states begin to implement these Medicaid changes, the focus will likely be on how effectively they can mitigate potential coverage losses. States with robust automatic data matching systems and comprehensive exemption criteria may be better positioned to prevent significant disenrollment. Policymakers and stakeholders will need to closely monitor the impact of these changes and potentially adjust strategies to ensure that eligible individuals maintain their coverage. The outcomes of these efforts could influence future policy decisions and the overall approach to Medicaid eligibility and work requirements.
