Another 10,000 children were confirmed to be ineligible for Medicaid program as state continues disenrollment process

By Kyle Pfannenstiel, Idaho Capital Sun, August 15, 2023

At least 55,300 Idaho children have lost access to Medicaid health insurance since April as the state continues to disenroll people from the program after pandemic-era protections have ended, data recently released by the state health department shows.

The data, which includes numbers through the end of July, shows more than 33,111 of those 55,300 children were part of a group of Idahoans called Medicaid Protection, who were flagged to be removed from the program — either for being ineligible, or because they didn’t respond to the state’s requests for information. The child disenrollment data for Idaho was provided by Idaho Voices of Children and was obtained from the Idaho Department of Health and Welfare through a public records request.

Most of the kids that are part of the Medicaid Protection group were removed for not replying to the state’s requests for information. About 22,978 Idaho children were disenrolled for non-replies, while 10,133 were confirmed to be ineligible for the program, the data shows.

“Many working parents with low incomes only have Medicaid as an affordable health coverage option for their children. Seeing this many children lose their health coverage is shocking and should concern everyone in the state who cares about the health of children,” Idaho Voices for Children Analyst Hillarie Hagen said in a statement. 

Not responding to the state’s requests for information has been the reason most Idahoans were removed from Medicaid so far, the Idaho Capital Sun previously reported. 

Hundreds of thousands of children have lost Medicaid coverage across the U.S.

It’s unclear why about 22,000 children were removed from Medicaid in addition to Idaho re-evaluating the eligibility of people on Idaho Medicaid Protection, who were flagged as likely to be removed from the state program. 

The Idaho Department of Health and Welfare did not respond to questions asking why the children lost coverage, such as if they had aged out of Medicaid coverage for children. 

Nationally, children account for about 32% of all Medicaid disenrollments in 12 states that report the age of people being disenrolled, KFF reports. At least 537,000 kids have been disenrolled from Medicaid from those states, KFF reports. 

Idaho does not publicly report the age of Idahoans disenrolled on its Medicaid disenrollment online dashboard.

Health advocates worry that children being removed from Medicaid are still eligible for the program. 

Children, who are eligible for Medicaid until they are 20 years old, can be part of households that earn more money and still qualify for Medicaid. A single Idaho adult is eligible for Medicaid until they earn more than 138% of the federal poverty limit, but an Idaho child would still be eligible if their household earned 190% each year.

When people lose Medicaid due to “red tape” removal, or what the state calls “procedural” removals for non-replies, it creates a ripple effect that leads to more people being uninsured, said Joan Alker, executive director of the Georgetown Center for Children and Families. 

“That’s problematic for children, because children are less likely to go to employer-sponsored coverage,” said Alker, whose center has tracked Medicaid disenrollment efforts across the country.

She said lower income workers often don’t get employer-based health insurance, and it’s even harder for their children. 

“It’s really hard to find affordable coverage through your job if you’re a low-wage worker,” Alker said.

Dr. Megan Haughton, a family doctor in Nampa, said she is already seeing fewer families come in for their annual appointments. It’s hard to see the long-term impact right now, she said, but it will become clear eventually. 

“From a physician standpoint, it’s hard, because when people have less coverage, they’re less likely to come in for appointments,” she said. “… It’s better to have those periodic appointments because it actually helps with the burden of health care costs, as things can be caught before they become a larger problem. We can be more proactive rather than reactive for a condition that might be starting.”

Children who are disenrolled from Medicaid should be moving to CHIP, another children’s insurance program, Alker said. But Idaho’s CHIP data has dropped while Medicaid enrollment drops — from 39,307 enrollees to 22,547 from April to the end of July, the data shows.

Alker calls that “concerning.”

CHIP enrollment “should be going up, if there are families whose income went up during the pandemic, but they stayed in Medicaid, and now their income is determined to be too high. Then their child should be eligible to move over to CHIP unless their income has gone up a great deal,” Alker said.


What is Medicaid disenrollment?

A federal law during the COVID-19 pandemic stopped states from removing people from Medicaid. States may now remove people who no longer qualify. But Idaho didn’t stop processing renewals for people on Medicaid during the pandemic, and instead of removing ineligible people from the program during the renewal process, state officials flagged them as likely to be removed. 

The state health department flagged about 153,000 people in that time — either because they didn’t respond to the state’s requests for their information, or their records showed they were ineligible for Medicaid. Those people became what Idaho called the “Medicaid Protection” population.

Idaho has so far removed 103,408 people from Medicaid from the Medicaid Protection group, the state’s website reported Monday morning. Less than 30,000 people have remained on the program out of 133,194 accounts processed so far. 

Idaho plans to wrap up disenrolling people in Medicaid Protection by the end of August, but it will evaluate the eligibility of all Idahoans on Medicaid until February 2024.

To make sure you know when the Idaho Department of Health and Welfare is evaluating the eligibility of your Medicaid, update your address and contact info with the department. Go online to idalink.idaho.gov, or contact mybenefits@dhw.idaho.gov or call 877-456-1233.


FEATURED IMAGE:  About 22,987 Idaho children were removed from Medicaid for not replying to the state’s requests for information, while 10,133 were confirmed to be ineligible for the program, new data shows. (Getty Images)

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