Thousands of Alabamians will lose Medicaid coverage when pandemic protections end

An estimated 61,000 Alabamians could lose health care coverage through Medicaid as federal pandemic protections are rolled back this spring. The state will see the number of uninsured increase by more than 16%, according to a new report.

In Alabama, the number of people without health insurance is expected to increase by about 61,000, to about 432,000 total uninsured residents by June 2024. The state is expected to remove people from Medicaid who are no longer eligible this spring, as federal protections preventing states from removing Medicaid beneficiaries from rolls expire. The projections are part of a report by the Robert Wood Johnson Foundation and the Urban Institute, which drew on data from the Centers for Medicaid and Medicare Services.

“An increasingly pressing question is what happens to health coverage after the (declaration) expires and states resume normal eligibility determinations?” said the authors of the report.

Nationwide, an estimated 18 million people will lose Medicaid starting in April if the United States does not extend the pandemic health emergency created in 2020 under the Families First Coronavirus Response Act.

“An unprecedented number of people have enrolled in Medicaid since the start of the pandemic,” the report said. The group found that about 18 million more people joined Medicaid during COVID-19.

For some of these people who are currently losing their insurance due to job changes or increased income, it will be possible to obtain insurance through their employer. The study found that about 9.5 million people are likely to regain confidence through work. However, around 3.8 million more people nationwide will be uninsured once the protections expire, the groups estimate.

“Those most likely to move in and out of Medicaid eligibility are young adults, part-time workers, and people whose incomes are close to eligibility thresholds,” the report said.

In states like Alabama, which have not expanded Medicaid, more people are likely to fall through the cracks and run out of insurance once they are locked out of the program. Many states have expanded Medicaid since the Affordable Care Act was passed to cover people who earn too much to qualify for traditional Medicaid but too little to qualify for health plans on the market because they don’t earn 100 % of federal poverty level, about $18,310 for a family of two or $23,030 for a family of three. In Alabama, to qualify for Medicaid, a family of two must earn less than $15,372 a year.

Alabama is being urged to quickly remove people who are no longer eligible from Medicaid because federal funds to support the declaration of emergency will be withdrawn upon completion, according to the study.

For Alabamians who are eligible to switch to employer-based or federal market plans because they are no longer eligible for Medicaid due to an increase in income during the pandemic, their monthly health care premiums health will likely increase, according to the report. Overall, however, the number of people on Medicaid is expected to remain similar to pre-pandemic levels, the report said.

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