Millions of ineligible enrollees have been removed from state Medicaid programs over the past year. Medicaid is a means-tested welfare program, so states must properly and regularly assess income to ensure that only people with low-income and who meet eligibility requirements are enrolled. As a result of a stoppage of regular eligibility reviews during the COVID public health emergency, states did not remove people from their Medicaid programs from early 2020 until the spring of 2023.
By April 2023, nearly 20 million people, including children, were on Medicaid even though they were in a household with an income too high for the program. Many of them obtained employer-sponsored health insurance when they remained enrolled in Medicaid. In effect, taxpayers were sending payments to health insurers for Medicaid coverage for millions of people who were ineligible and had other coverage.
States began redeterminations and removals in the spring of 2023, and most states are ahead of where experts expected them to be at this point. However, insurers are reporting that they expect to retain many of the net new Medicaid enrollees added during the pandemic.
