New report: 15 million Americans could lose Medicaid in 2023. Congress must act.


December 15, 2022

A report released Thursday by prominent human needs advocacy groups warns that unless Congress takes action, 15 million people could lose Medicaid coverage after the Biden Administration ends the COVID-19 Public Health Emergency. 

The report, Shrinking the Medicaid Cliff: How Congress Can Prevent Health Care Equity Disaster by Protecting Eligible Families’ Health Care, was co-issued by the Asian & Pacific Islander American Health Forum, the Coalition on Human Needs, the Leadership Conference on Civil and Human Rights, the NAACP, the National Urban League, and UnidosUS. 

When Congress first approved COVID-19 relief legislation in spring 2020, it stipulated that states should not drop beneficiaries from the Medicaid rolls as long as a Public Health Emergency remains in place. But that declaration is expected to be lifted in 2023, perhaps even in early 2023. 

When that happens, as many as 15 million people will be at risk, even though most of these recipients would still qualify for aid. They face a health care nightmare – their coverage could end not because they no longer qualify but because of missing paperwork or other administrative reasons. 

A majority of the 15 million people are people of color, the report notes. Their numbers include 4.6 million Latinos, 2.2 million Blacks, and nearly a million Asian Americans and Pacific Islanders. The report states that an estimated 5.3 million children would lose Medicaid, three-fourths of whom would be eligible, but would lose coverage for administrative reasons. 

The report finds that this would be by far the largest one-year drop in the history of Medicaid. And it would affect more than six times the number of people – about 2.2. million – who are currently denied coverage because of the “Medicaid coverage gap.” These 2.2 million, also largely people of color, live in states that have not expanded Medicaid. 

These losses will occur if Medicaid continues to operate as it did before the pandemic. But the report proposes steps Congress should take. Specifically, it recommends three changes to the Medicaid statute to avoid this health care catastrophe: 

  1. “A state’s administrative terminations should be placed on hold if the state does not achieve target outcomes or if HHS finds state policy is causing the preventable termination of eligible people. 
  1. “The outcome standards that must be achieved for a state to terminate Medicaid for administrative reasons should represent average state performance before the pandemic. Families should not be terminated because of missing paperwork until their state has done at least an average job eliminating needless paperwork. 
  1. “No state would be allowed to terminate a SNAP recipient who is a child, a pregnant or post-partum beneficiary, or an expansion adult, unless recent earnings records show income above Medicaid levels.” 

“America’s low-income families are rapidly approaching a massive Medicaid cliff,” the report states. Congress must act now to dramatically shrink the magnitude of loss, protecting health care for millions of eligible people who disproportionately live in communities of color.” 

You can write Congress and demand that we avoid going over this Medicaid cliff – click here. (Note that that same link on the UnidosUS website will allow you to also ask Congress to expand the Child Tax Credit and protect DREAMers.)