MONTGOMERY, Ala. — The process by which the Alabama Medicaid Agency has been purging its rolls of recipients no longer eligible for the low-income health care program has come to an end with nearly 300,000 fewer Alabamians enrolled in the program one year later.
Known as Medicaid unwinding, Medicaid agencies across the country have been sifting through their rolls since early last year, redetermining members’ eligibility after the expiration of pandemic federal protections that prohibited states from removing people from the program. Reasons for removal can include no longer meeting income requirements or moving out of state.
In Alabama, this meant that for every month since June of 2023, an average of 23,186 Medicaid recipients were culled from the rolls. That is, until July of this year, per the agency’s new report.
In July, for the first time since June of 2023, the number of Alabamians enrolled in Medicaid rose when compared to the previous month, increasing by 1,292 to roughly 1.09 million.
Peak enrollment was seen in June of 2023 at 1.3 million.
Melanie Cleveland, communications director for the Alabama Medicaid Agency, told Alabama Daily News Wednesday the agency has “completed the COVID-19 unwinding process.”
However, further details as to what portion of the nearly 300,000 Alabamians that lost coverage because their income changed or because of procedural reasons, such as not submitting paperwork on time, will not be available until reports from September are complete.
“Medicaid recipients can have their coverage reinstated if they are still eligible and they contact Medicaid within 90 days of their termination date,” Cleveland told ADN. “The Agency has continued efforts to educate recipients when it is time for them to renew their Medicaid through the mail, social media, and by electronic notifications.”
Stephanie Azar, commissioner for the Alabama Medicaid Agency, previously projected that the Medicaid unwinding process would take roughly one year.
With enrollment now stabilizing, the remaining 1.09 million Alabamians enrolled in Medicaid represent a slight increase when compared to pre-pandemic levels. In September of 2019, total enrollment was at approximately 1.05 million.
More than 94 million Americans are currently enrolled in Medicaid. As of Sept. 12, roughly 25.2 million lost coverage since Medicaid unwinding began.
When compared to other states, Alabama ranked 23rd in terms of its disenrollment rate, losing approximately 34% of its enrollees over the one-year Medicaid unwinding period. At 57%, Montana saw the highest disenrollment rate in the nation, and North Carolina saw the lowest at 12%.
One factor that sets Alabama apart is that it remains one of just ten states that has yet to expand its Medicaid program eligibility under the provisions outlined in the 2010 Affordable Care Act. The program’s eligibility requirements are among the strictest in the country.
To be eligible for Medicaid in Alabama, residents must meet certain criteria, such as being pregnant or having a disability, and must also adhere to strict income caps that differ based on certain criteria. For those with disabilities, for instance, their income cannot exceed $963 per month, or $11,556 a year.
While some Democratic state lawmakers and advocacy groups have long called for Medicaid expansion, such calls face an uphill battle with the continued skepticism of Gov. Kay Ivey, and a lack of consensus among the Legislature.