What Happens When a State Kicks a Million or So People Off of Healthcare Plans?

They go without, show up at ERs, or go to overcrowded Clinics. The costs of the first two end up being far more than a healthcare plan. And at clinics the healthcare may be less because of less resource. It really makes a lot of sense for a state to do this also. In the end, they will pay for it and pay more.

I did not mention some of them die.

Jackasses Texas Remove(s) 1.7M People from Healthcare Plan(s)

Texas has removed millions of residents from health-care programs as part of a national “unwinding” process that began after the end of the COVID-19 public health emergency.

According to new data from health policy research non-profit the Kaiser Family Foundation (KFF), Texas leads the nation in Medicaid and Children’s Health Insurance Program (CHIP) disenrollments, with over 1.7 million people having had their coverage terminated between March 2023 and October 2024.

While some individuals may transition to employer-sponsored plans or the Affordable Care Act marketplace, health advocates have warned that many—especially children and low-income families—could be deprived of insurance altogether.

Why It Matters

The high level of post-pandemic disenrollments raises concerns about health-care coverage gaps for America’s more vulnerable populations.

Texas already suffers from the highest uninsured rate in the country. Axios reported this in August, citing Census Bureau data. These cuts could push this higher, putting additional pressure on hospitals, emergency services, as well as the individuals and families left without coverage.

While the unwinding process is meant to ensure only eligible individuals remain on Medicaid, the sheer scale of coverage losses suggests that many may be falling through the cracks.

The continuous enrollment provision, passed by Congress as part of the Families First Coronavirus Response Act in March 2020, required states to ensure coverage for enrollees during the pandemic, who were spared the need to go through regular eligibility redeterminations.

The policy ended on March 31, 2023, with eligibility checks and disenrollments recommencing for those who were either ineligible, or whose redetermination could not be completed due to administrative hurdles.

Since the unwinding process began, over 25 million million people have been disenrolled from CHIP and Medicaid, according to KFF.

Texas’ high rate has been linked to the state’s strict eligibility reviews and procedural issues, as well as many Texans failing to file renewal paperwork or encountering bureaucratic barriers.

According to the Center on Budget and Policy Priorities, states have displayed “extreme delays in processing new applications in some states; many of these applications are from people who lost coverage during their renewal.”

While some individuals may transition to employer-sponsored plans or the Affordable Care Act marketplace, health advocates warn that many—especially children and low-income families—could be left without any insurance.

Journal of the American Geriatrics Society

Recent Journal research published in it last March warned of the “substantial risk” of Medicaid disenrollment on children, those aged 65 and above, and those with disabilities. AB: It still did not matter much like the damage being caused by Musk and Trump.

“Coverage loss for these vulnerable individuals may be mitigated by state policies to enhance accessibility of Medicaid platforms, prioritize access to patient navigators, and simplify non-[ modified adjusted gross income] redetermination protocols,” the authors wrote. AB: This is a typical Texas reaction to people who can not afford healthcare and a desire to disenroll them.

Health care analysts at the law firm Norton Rose Fulbright in June said that the mass disenrollment process had resulted in a “ripple effect across the healthcare industry,” as uninsured individuals are forced to seek care through other parts of the health-care system.

What Will Happen Next?

KFF estimated in April 2023 that between 8 million and 24 million people would lose coverage as a result of the unwinding process. This includes up to 6.8 million who likely will remain eligible but encounter administrative challenges in renewing their coverage.

“Efforts to conduct outreach, education and provide enrollment assistance can help ensure that those who remain eligible for Medicaid are able to retain coverage and those who are no longer eligible can transition to other sources of coverage,” KFF said.