700,000 Michiganders have lost Medicaid coverage since the end of automatic enrollment

A special federal rule put in place at the start of the COVID-19 pandemic allowed people to stay on Medicaid rolls without proving their eligibility and prohibited states from removing them. Under the rule, the number of Michiganders who were enrolled in Medicaid ballooned to 3 million.

Only about half of those individuals have retained Medicaid coverage since the rule was lifted last year.

The Michigan Department of Health and Human Services has renewed Medicaid and Healthy Michigan Plan coverage for more than 1.4 million residents as of February. Since the renewal period started last June, roughly 700,000 people have lost coverage, according to Lynn Sutfin, a health department spokesperson. That’s about the same number of residents she said had been added to Michigan’s Medicaid caseload during the pandemic emergency.

A federal spending bill ended the rule on March 31, 2023, forcing states to review the qualifications of Medicaid beneficiaries over a 12-month period ending in May. 

Health officials and advocates nationwide were fearful that those who would otherwise qualify for Medicaid would be left off the rolls after the COVID-19 emergency was ended, leaving them unable to pay for doctor’s visits, prescription drugs or other medical services.

Medicaid is a joint federal and state program that provides health coverage for millions of Americans, including children and pregnant people. Under the 2010 Affordable Care Act, states were offered the option of receiving federal matching funds to expand their Medicaid programs to cover anyone with income up to 138% of the federal poverty level ($31,200 for a family of four). Once the redetermination process picked back up, states that haven’t expanded Medicaid, including Florida, Georgia and Texas, have seen high rates of child disenrollment compared to states such as Michigan that have adopted Medicaid expansion.

The majority of people dropped from Michigan’s rolls, or 560,000 individuals, lost coverage for procedural reasons because they failed to fill out and return their renewal paperwork, according to state data. Roughly 127,000 individuals were otherwise determined ineligible, primarily because they no longer met the income requirements for Medicaid.

“As we have never conducted such an encompassing renewal process, we do not have an estimate or expectation for how many individuals will no longer be eligible for Medicaid coverage once the redetermination process is completed,” Sutfin said. She added that approximately 300,000 more Michigan residents need to go through the renewal process in May, with a June 30 deadline to complete their paperwork.

To reduce the number of residents at risk of losing coverage, Sutfin said MDHHS has taken multiple avenues to notify those with Medicaid plans of the recertification requirement, including letters in the mail, emails and robocalls. 

The state has also used various approaches to provide people with health coverage, Sutfin said, such as renewing Medicaid for people under the Supplemental Nutrition Assistance Program or Temporary Assistance for Needy Families program, and extending renewals until May for beneficiaries undergoing lifesaving treatment for illnesses including kidney disease and cancer. 

People who were disenrolled for procedural reasons but are later found to still be eligible have 90 days after disenrollment to submit the information required. If they do so, they will be reenrolled and their benefits will be restored retroactively, with any medical bills incurred during that time covered once their benefits are reactivated.

MDHHS is advising all households to complete and return their renewal paperwork even if they don’t think they’re eligible for Medicaid, as some family members may still qualify.“This has been a collaborative effort with many partners and advocates assisting us by communicating with and informing beneficiaries,” MDHHS Director Elizabeth Hertel said in a statement. “I’m grateful for all the work and coordination that has gone into helping make sure those who are eligible retain their benefits.”