(HealthDay News) — A Medicaid “glitch” is removing health care coverage for potentially millions of children, US health officials warned last week.
Automated systems involved in a large-scale eligibility review are causing entire households to be removed from Medicaid coverage, according to a news release from the US Centers for Medicare & Medicaid Services (CMS).
However, the children being removed from Medicaid may still be eligible based on family income even if their parents are not.
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This eligibility review is happening now because the federal law that prohibited states from removing people from Medicaid during the pandemic is no longer in effect. While the law was in effect, Medicaid enrollment grew from 71 million in February 2020 to 94 million in April 2023, the Associated Press reported.
Now, states are returning to annual eligibility determinations. The process of determining eligibility can include using computer programs to review income and household information, including whether someone received unemployment benefits or food assistance, and sending notices asking people to verify their eligibility. Those who do not qualify or do not respond can be dropped by Medicaid. But most states allow children to have coverage at much higher household income levels than for adults, the AP reported.
In many states, “eligible kids are not being successfully renewed, and that is a violation of federal requirements,” Daniel Tsai, director of the CMS Center for Medicaid and Children’s Health Insurance Program Services, told the AP.
CMS is giving states until September 13 to report whether this glitch is happening in their states. They are being told to pause procedural terminations, reinstate coverage for those inadvertently dropped, and find a solution to prevent this until the automated system is fixed, according to CMS.
