Cropped shot of two elderly people discussing a medicaid renewal document

Medicaid beneficiaries continue to be disenrolled for simple procedural reasons, highlighting the need for states to implement “safeguards” against wrongful termination, according to a recent research article.

“Almost half of the approximately 15 million people who could lose Medicaid during unwinding would be terminated for procedural grounds owing to the paperwork difficulties of the renewal process itself, not because they were actually ineligible,” the researchers wrote in HealthAffairs. “The sheer volume of cases that must be reviewed, coupled with the complexity of Medicaid eligibility rules, staff shortages and worker turnover, means that mistakes are inevitable.”

One of these mistakes was the “ex parte” glitch, which wrongfully terminated hundreds of thousands of Medicaid beneficiaries because of their family members’ ineligibility. In some states, renewal programs left untouched during the public health emergency period of continuous enrollment meant many beneficiaries’ personal information was outdated. These individuals could not be contacted when it came time to renew, and so many were stricken from the rolls without having ever received notice, according to the researchers.

Problems in Florida 

This unwinding has inequitably affected some groups, researchers noted. For example, Spanish-speaking people in Florida reportedly were subjected to hours-long wait times before being able to speak with a Medicaid agent who spoke Spanish. And those who were able to make contact with the state’s Medicaid agency sometimes received information “incomprehensible even to people who can read English,” the researchers said.

More than 800,000 beneficiaries have been terminated from Florida’s Medicaid rolls since unwinding began, according to data from KFF. More than half of these were due to procedural reasons rather than actual cases of ineligibility. In August, plaintiffs filed a lawsuit against the state for its ineffective methods of notifying beneficiaries for re-enrollment, leading to a greater proportion of wrongful procedural terminations.

“Almost half of those becoming uninsured (118,500 adults and children) could have serious, chronic health problems like diabetes, cardiovascular disease, asthma, autism, cerebral palsy or other diseases that require ongoing medical care and medications,” the researchers noted. “Thousands could end up requiring emergency medical care, hospitalization and even death that could be prevented with access to better health care.”

The researchers called on greater financial support for state Medicaid programs, and it may be coming soon. Federal lawmakers in October proposed a solution that would financially support Medicaid home- and community-based services to help beneficiaries retain access to those services that can prevent hospitalization and emergency department visits.