‘Voices of Medicaid’: Report Shows Continuity of Medicaid Coverage Improves Enrollees Health and Well-Being

FOR IMMEDIATE RELEASE: November 15, 2021

FOR MORE INFORMATION: Jeff Van Ness, (202) 204-7515, jvanness@communityplans.net



WASHINGTON—A new report from the Association for Community Affiliated Plans (ACAP) and NORC at the University of Chicago assesses the negative impact Medicaid churn has on enrollee health and well-being and shows how continuous Medicaid eligibility, as assured by maintenance of effort rules during the COVID-19 public health emergency, offers a solution.

Millions of people enroll in Medicaid or the Children’s Health Insurance Program (CHIP) each year only to lose coverage shortly after for reasons often unrelated to their underlying eligibility— a burdensome phenomenon known as eligibility “churn” which has been shown to contribute to loss of coverage, foregone care, and worsened health outcomes. Eliminating churn for all Medicaid enrollees has been an ACAP policy priority for more than a decade.

Since March of 2020, enrollees have been protected from churn due to maintenance of effort rules in the Families First Coronavirus Response Act that require states to pause redeterminations of eligibility for the length of the COVID-19 public health emergency.  Recently, Congress has shown support for ending churn by including continuous eligibility requirements for children and postpartum mothers in the Build Back Better Act.

To better demonstrate the importance of continuous coverage on health outcomes, ACAP and NORC at the University of Chicago conducted interviews with 15 Medicaid enrollees who would typically be at risk of churning but were protected during the public health emergency.

They include:

  • A father whose children lost Medicaid coverage after he worked overtime for a few weeks. He accrued a $1,600 bill when one of those children needed care during that gap in coverage.
  • A man who contracted COVID-19 shortly after having open-heart surgery and, without Medicaid, would not have sought lifesaving treatment at a hospital out of fear of incurring a large bill.
  • A woman whose Medicaid coverage allowed her to see various specialists to obtain a diagnosis and, eventually, a necessary procedure during which surgeons located an aneurysm that, left alone, would have killed her.
  • A mother who lost her husband and her job due to the pandemic whose Medicaid coverage allows her to access treatment for substance use disorder and to access the regular care she and her two children need.

“Our report is not only a testament to the importance of continuous eligibility but also a reminder of Medicaid’s vast reach and how tightly it is woven into the fabric of our social safety net,” said ACAP CEO Margaret A, Murray. “The people featured in this paper could be your friends, your neighbors, or your family members—real lives we cannot allow to keep slipping through tears in the fabric. Continuous eligibility makes Medicaid work better for everyone. To advance health equity across the board, we must start by ensuring that every American has access to continuous, high-quality, affordable coverage when they need it.”

“The people we interviewed all spoke to the critical – even, as some said, lifesaving – importance of their Medicaid coverage. But without the eligibility protections in place because of COVID-19, several of their stories would have ended differently,” said Ashley Palmer, senior research scientist at NORC and one of the paper’s authors. “Our research suggests 12-month continuous eligibility for all people on Medicaid would benefit both the people who shared their stories in this report and many of the tens of millions of people in the United States for whom Medicaid is a lifeline.”

Read the report here.

About ACAP:

ACAP represents 78 health plans, which collectively provide health coverage to more than 20 million people. Safety Net Health Plans serve their members through Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), the Marketplace and other publicly-sponsored health programs. For more information, visit www.communityplans.net.

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