MONTGOMERY, Ala. — A total of 278,238 Alabamians lost Medicaid coverage from June 2023 through June 2024, according to a new report from the Alabama Medicaid Agency.
Like other states, Alabama Medicaid enrollment has declined significantly since last summer due to the expiration of pandemic-era federal protections. Now that those protections have expired, Alabama has been sifting through its rolls to redetermine member eligibility, a process referred to as Medicaid unwinding.
According to the report, there were approximately 1.1 million Alabamians enrolled in Medicaid as of the end of June, close to 300,000 less than the state’s peak enrollment of almost 1.4 million in June of 2023.
In Jefferson County alone, there were 35,151 fewer Medicaid recipients in June when compared to the previous year; enrollment in Mobile County dropped by 27,256; in Madison County, by 16,984; and in Montgomery County, by 15,578.
Nationally, more than 25 million Americans have lost Medicaid coverage during the unwinding process.
The Alabama Medicaid Agency does not disclose why Medicaid recipients lost coverage, though reasons can vary from members becoming no longer eligible for the program due to their increased income, moves out of state or for procedural reasons.
Broken down by ethnicity, there were 103,842 less Black Alabamians enrolled in Medicaid in June when compared to the same time last year, and 122,334 less white Alabamians.
In June of 2023, white Alabamians were 38.6% of the nearly 1.4 million enrolled in the low-income health care program. Black Alabamians made up 37.9%.
One year into the unwinding process, however, and Black Alabamians now represent 38% of the remaining 1.1 million enrollees, to white Alabamians are 37.2%.
Broken down by age, there were 111,706 less children enrolled in Medicaid in June compared to the same time last year, and 166,532 less adults. However, Alabama has among the lowest rates of uninsured children due to alternative state programs like ALL Kids, which covers close to 90,000 children.
Women saw a far greater reduction in Medicaid enrollment over the last year, with 165,601 less women enrolled in the program compared to 103,637 less men. However, the greater share of women disenrolled from Medicaid aligned proportionally with their enrollment base, which has remained at just under 60% throughout the year, compared to mens’ 40%.
When comparing June with the previous month, the reduction of Medicaid enrollees was generally on par with previous months, with 26,504 less Alabmians enrolled in the program in June compared with May.
State lawmakers this year began exploring the possibility of expanding Medicaid through a private-public partnership model, however, Gov. Kay Ivey has remained skeptical of the idea, expressing concerns over costs.
The Alabama Medicaid Agency was allocated $955 million from the state General Fund for fiscal year 2025, an increase of $91 million from the current year. Medicaid is the General Fund’s largest expense.