Millions of children have lost their health care coverage; 'procedural' or 'red tape' problems are to blame

Babies and children are missing needed check-ups
because of coverage loss. (Adobe Stock photo)

Government red tape has caused millions of children to lose their health care coverage. Joyce Frieden of MedPage Today reports, "A total of 4.16 million fewer children were enrolled in Medicaid or CHIP at the end of last year compared with the month before each state began its Medicaid and CHIP 'unwinding' process, a report from Georgetown University's Center for Children and Families found.

While some families most likely moved to different coverage, many did not. Joan Alker, the center's executive director, told Frieden, "Federal researchers estimate that three-quarters of children who will or have lost Medicaid during the unwinding will remain eligible for Medicaid but are losing coverage for procedural or 'red tape' reasons. Nationwide, a shockingly high 70% of people losing Medicaid are doing so for procedural reasons."

Some states dropped more children enrollees than others. "Texas, Florida, Georgia, and California saw the largest numeric declines in Medicaid/CHIP child enrollment," Frieden writes. "[That reduction] accounts for half of the total national decline, the researchers said. . . . Eight states -- Montana, Idaho, South Dakota, Arkansas, New Hampshire, Utah, Alaska, and Colorado -- disenrolled so many children in 2023 that they had fewer children enrolled at the end of the year than prior to the pandemic in early 2020."

Coverage loss has become a daily barrier to care in pediatrician offices. Kimberly Avila Edwards, a pediatrician from Texas, told Frieden, "Parents are checking in for their child's appointment, only to learn that their child is no longer covered due to a paperwork issue. These situations are all avoidable, but they are now the daily reality in pediatric offices across the country."

Alker told Frieden, "States should make efforts to reach out to families with trusted community partners and resources to re-enroll eligible children, and consider systems reforms to make the process go more smoothly."

To help address coverage loss, Edwards is "advising parents whose children have been disenrolled to 'Please be proactive -- if you receive a notice, act quickly and respond in the time frame provided,'" Frieden reports. "'Secondly, [we're] asking them to seek assistance from community health centers or patient advocates and contact their local Medicaid agency.'"