At least 1 million people have been kicked off Medicaid since coverage protections implemented during the Covid-19 pandemic expired in April, according to data published by the Kaiser Family Foundation on Monday.
The total number of people kicked off Medicaid is likely higher because only 20 states are making those figures publicly available, according to KFF.
Many people are losing Medicaid even though they likely remain eligible.
A majority of people kicked off Medicaid in 11 states lost their coverage because they did not complete the paperwork or because the authorities were unable to contact them, according to the KFF report.
Health and Human Services Secretary Xavier Becerra told governors in a letter Monday that he was deeply concerned people who remain eligible for Medicaid are losing coverage because of paperwork issues.
Becerra called on the governors to do more to ensure people remain enrolled in the program.
"I am asking that we redouble efforts, expand what is working and reach out even further to ensure that no eligible beneficiary experiences a loss in coverage that could have been avoided," Becerra wrote.
Becerra told the governors that he was particularly concerned children will lose insurance if their parents are kicked off Medicaid. The secretary said he's worried parents may not understand that their kids are still eligible for Medicaid or the Children's Health Insurance Program.
"Even if parents think they are no longer eligible, states should ask parents to still fill out their renewal forms for their children," Becerra said. "We also urge you to include messaging about Medicaid renewals through schools, early childhood programs, and summer camps, to parents."
Covid safety net ends
Congress basically banned states from removing people from Medicaid coverage during the Covid public health emergency. These protections led to a historic surge in enrollment in the insurance program, which generally provides coverage for people with lower incomes.
Those protections expired in April after Congress passed spending legislation in December that gave states the greenlight to start reviewing peoples' eligibility for the first time in years.
Medicaid is administered by the states but heavily financed by the federal government.
States are not allowed to terminate a person's coverage simply because renewal paperwork sent to the address on file was returned as undeliverable. Authorities are required to try to contact people during the renewal process through more than one communication method.
Becerra said HHS would use its authority to make sure states are complying with these conditions.
HHS estimates about 15 million people will lose Medicaid coverage as states review eligibility. Many of these people will be eligible for insurance through the Affordable Care Act marketplace or an employer.
But 6.8 million people are expected to lose Medicaid coverage even though they remain eligible.