CHN’s COVID-19 Watch: Tracking Hardship, March 31, 2023


March 31, 2023

COVID-19 HardshipMarch 31, 2023 

The Medicaid unwinding edition. Early in the pandemic, Congress gave states more Medicaid money to address COVID-19. In return, states were not allowed to drop people from their Medicaid rolls. That ends tomorrow. Beginning April 1, five states – Arizona, Arkansas, Idaho, New Hampshire, and South Dakota – will start ending Medicaid coverage for those who have not demonstrated their continued eligibility. Almost every other state will follow in May, June, or July. And by roughly one year from now, millions will have lost access to health care, some because they now earn too much to qualify for Medicaid. But millions may lose Medicaid or Children’s Health Insurance Program (CHIP) coverage despite still being eligible -because of bureaucratic red tape. Of the millions of children expected to be dropped, about three-quarters will really still be eligible. Of those losing coverage, more than half are expected to be people of color, including nearly 4.6 million Latinos, about 2 million Blacks, and almost 1 million Asian Americans and Pacific Islanders. About half of Blacks and Latinos losing Medicaid will still be eligible, if many states do not make efforts required by law to offer better assistance – such as functioning call centers so Medicaid beneficiaries can get help, and use of available administrative data to verify eligibility (if people receive SNAP benefits, for example, the state already has data it needs).   

What happens to those who are cut off? Some will be able to obtain coverage through Affordable Care Act marketplaces; a few may be able to get insurance at work. Most children, if they aren’t still eligible for Medicaid, will qualify for CHIP. But millions will not replace what they currently have. The Biden Administration is trying to get states to reach out to enrollees effectively, and not just terminate people because they don’t answer a misaddressed letter. Indeed, every Friday afternoon for months now, the Centers for Medicare and Medicaid Services (CMS) has been hosting calls with 300 state officials to discuss the eligibility redeterminations. 

 One hopeful sign: the Biden Administration, when it sees that states are not following the law in easing the redetermination process, will prevent them from terminating people until the state comes up with a plan to improve. That should help, but some states have a long track record of rushing to deny aid. With millions in danger of losing their health care, and with other critical services endangered by a hostile U.S. House, now is a perfect time to remind Congress of the importance of investing in human needs programs. Click here. 


15 million/ 

6.8 million 

According to a Department of Health and Human Services analysis,15 million people will lose Medicaid this year, including 6.8 million who will still be eligible but will be dropped from the rolls due to bureaucratic red tape, if states do not improve their practices. Up to 6.7 million children are at risk of losing Medicaid. In all, Blacks and Latinos are expected to be disproportionately affected, along with people with disabilities. Tweet this.


Nearly 3 in 4 

Of the millions of children expected to be dropped from Medicaid or CHIP, nearly three-quarters will still be eligible, but parents either won’t be reached or can’t navigate the bureaucracy. Tweet this.

2.7 million 

The number of people who could lose Medicaid coverage in Texas alone. Advocates fear that Texas is proceeding more quickly to drop people from the rolls than federal officials recommend. People in non-Medicaid expansion states – like Texas, mostly in the South – will be disproportionately affected. Tweet this.

Nearly 3 in 4 

States that opted against Medicaid expansion, or had just recently adopted it, accounted for nearly three-fourths of rural hospital closures between 2010 and 2021, according to the American Hospital Association. Tweet this.



In a 2021 analysis, researchers for the National Bureau of Economic Research estimated that in one four-year period, 19,200 more adults aged 55 to 64 survived because of Medicaid expansion, and 16,000 more would have lived if that coverage was nationwide. Tweet this.


42 million 

The number of children covered by either Medicaid or CHIP. That’s more than half of the children in the U.S.



The number of additional North Carolinians who will be covered by Medicaid after state lawmakers approved expansion this month. The law will expand Medicaid to adults who make up to 138 percent of the federal poverty level, or about $41,000 for a family of four. The new law will take effect as early as June.



When adjusting the data for age and comorbidities, Arizona had the highest COVID-19 death rate (581 deaths per 100,000 people), followed by D.C. (526 per 100K), and New Mexico (521 per 100K). Hawaii had the lowest death rate (147 per 100K), followed by New Hampshire (215 per 100K), and Maine (281 per 100K).



Moderna, which received billions of dollars from the federal government for research, guaranteed purchases, and expert advice to help develop and produce its successful COVID-19 vaccine, has announced it will increase the cost of a vaccination from $26 to $110 – or possibly even to $130, now that the public health emergency is ending.



Life expectancy in the U.S. fell for the second consecutive year in 2021, when it reached 76.1 years. Other comparable countries, meanwhile, saw a rebound in life expectancy in 2021, compared with 2020 – 82.4 years. The U.S. has a lower life expectancy than Cuba, Lebanon, and the Czech Republic.





COVID-19 Watch