The Great Medicaid Unwinding
The American healthcare system is facing a significant challenge, referred to as the "Great Medicaid Unwinding". This crisis has been triggered by the expiration of a pandemic-era policy, leading to millions of Americans losing their healthcare coverage.
Background
Medicaid, a government-sponsored program, provides health coverage to some of the most vulnerable populations in the United States. However, the recent expiration of a pandemic-era policy known as the "continuous coverage provision" has led to a significant reduction in the number of beneficiaries.
The continuous coverage provision was implemented during the Covid-19 public health emergency and compelled states to keep Medicaid beneficiaries continuously insured. The policy greatly boosted enrollment, providing essential healthcare coverage during a critical time.
The Unwinding
In April 2023, this provision expired, leading to what experts are calling a great "Medicaid unwinding". This has already resulted in nearly 8 million beneficiaries being disenrolled from the program.
The consequences of this unwinding are severe and far-reaching. For example, Patricia Jones, a 62-year-old West Virginia woman with heart problems and a recent bloodstream infection, was recently dropped from Medicaid because her disability survivor’s benefits were $149 too high to qualify. She has yet to find alternative coverage.
Experts predict that as many as 24 million enrollees might lose their coverage by the time the unwinding is done. These giant numbers dwarf the coverage losses of the early 1980s, and widespread harm is sure to follow.
The Future of Medicaid
The so-called "Medicaid unwinding" isn’t as new as it may seem. Before the pandemic, large numbers of people lost Medicaid coverage every year due to shifting eligibility at the margins and administrative snafus. This feature—inherent to many means-tested programs—has always compromised coverage and caused suffering for those who depend on this critical program.
Such discontinuities in coverage are all too common in the fragmented American insurance system, and they undermine the very essence of what medical care can do.
As we move forward, it's crucial that policymakers address these issues to ensure that all Americans have access to affordable and comprehensive healthcare. The Great Medicaid Unwinding serves as a stark reminder of the challenges we face in achieving this goal.
