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Medicaid enrollment declines by more than 22,300 in July

MONTGOMERY, Ala – Between June and July, Alabama’s Medicaid enrollment declined by 22,313 as millions nationwide continue to grapple with the expiration of pandemic-related Medicaid protections.

While Alabama has among the strictest Medicaid eligibility requirements in the country, residents were protected from being expunged from the federal and state-funded health insurance program during the COVID-19 pandemic. Those federal protections expired on March 31, which began a nationwide period of disenrollment for people who no longer met Medicaid eligibility.

Melanie Cleveland, communications director for the Alabama Medicaid Agency, told Alabama Daily News Monday that while the majority of Alabamians who lost health insurance through the state’s Medicaid program may have been terminated due to the expiration of federal protections, many of them lost their coverage due to other factors.

“During COVID unwinding, some terminated recipients may be reinstated since they have 90 days from their termination date to complete the renewal, and if they are still eligible, their coverage may be reinstated back to the date of termination,” Cleveland said.

“The total disenrollment decrease from June to July should not be translated as the number of recipients terminated. The majority may have been terminated, but not all. Some recipients may have moved out of state, passed away or asked to be removed from coverage.”

Alabama Medicaid has not said how many people to-date have been removed from the rolls because of the post-pandemic unwinding. Blue Cross and Blue Shield of Alabama previously estimated that more than 120,000 could lose coverage in the process. Earlier this year, enrollment was more than 1.2 million.

For children and pregnant women to qualify for Medicaid, a family of four this year has to earn $43,800 or less. But in order for a caregiver of a child on Medicaid to qualify for care, their income has to be much less, about $5,400 a year in a family of four.

Robyn Hyden, director of Alabama Arise, a nonprofit organization that advocates for low-income Alabamians, told ADN Monday that were state lawmakers to expand Medicaid, hundreds of thousands of Alabamians could receive access to health care, with little to no cost.

“For years, Alabama Arise and our members have advocated for Alabama to expand Medicaid and close the health coverage gap,” Hyden told ADN. 

“We are leaving millions of federal funds on the table, and we have hard-working Alabamians – cooks, construction workers, barbers, child care workers – who cannot afford coverage, and some of them may be losing coverage this year because of the end of the federal public health emergency.”

Furthermore, Hyden pointed to a recent trend of health care providers leaving the state, all of whom cited Alabama’s refusal to expand Medicaid as the reason for their departure.

“I’m distressed by news not only of people losing coverage, but of more providers leaving the state, so this is impacting every county, every region of the state, and I hope that lawmakers are feeling that urgency of finding some solution,” Hyden said, referring to the health provider Health at Home, which recently laid off nearly 800 employees after announcing its departure from the state.

In March, the House Health Committee held a public hearing on coverage gap and who in the state is working without health insurance, but did not discuss the possibility of Medicaid expansion.

Alabama Democrats have pushed for the state to expand Medicaid for years, but have been unsuccessful in the Republican-controlled Legislature, whose leaders have pointed to the costs to expanding Medicaid as the primary reason for not doing so. Proponents of expanding Medicaid, such as Rep. Mary Moore, D-Birmingham, have instead pointed to the wealth of federal funding provided to states for expanding the program.

“The amount of money (federal funding) brings to help all of those counties that don’t have health departments, clinics… it’s just staggering in this state,” Moore previously told ADN. 

“And then people will refuse Medicaid expansion when the health care is so needed. It would help with job development; companies don’t want to invest in many areas of Alabama because we don’t have health care.”

Expanding Medicaid in Alabama, according to a 2022 study by the Public Affairs Research Council of Alabama, would increase the state’s Medicaid expenditures by $225.4 million per year over the next six years. 

Coupled with federal assistance provided to states by expanding Medicaid, however, Alabama would yield an average annual Medicaid savings of $397.8 million over those six years, according to the Public Affairs Research Council of Alabama. 

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