On May 24, the Congressional Budget Office released estimates that 15.5 million people will lose Medicaid over the next two years. The reason: Twenty percent of Medicaid enrollees are ineligible for the program because states have not conducted eligibility reviews for more than three years.
Medicaid is a welfare program only for people with low income. But in the March 2020 Covid legislation, Congress increased federal Medicaid payments to states conditional on states halting eligibility reviews for program enrollees. Starting in April 2023, the higher federal payments began phasing down (they will end by the end of the year), and states could begin cleaning up their Medicaid rolls.
Most of the ineligible recipients make too much money to qualify, and nearly 5 million are concurrently enrolled in employer-provided coverage. Ensuring proper enrollment is important for preserving resources and access to care for those eligible as well as for taxpayers who finance Medicaid. Federal improper payments in Medicaid reached $99 billion in 2022.
States need to remove people who provide information that shows they are no longer eligible as well as people who choose not to respond to states’ requests for information.
