NAHC Analysis: Medicaid Unwinding Impacting Thousands of Older Adults and People with Disabilities

Beginning in April, state Medicaid agencies have begun disenrolling individuals from the program for the first time since 2020 due to the end of COVID-era eligibility requirements. This “unwinding” process represents one of the largest issues in Medicaid policy, with an estimated 15-20 million individuals likely to lose Medicaid coverage over the next 12 months.

According to a recent report from the Kaiser Family Foundation, at least 3.8 million individuals have already been removed from Medicaid in the 41 states where data is available. CMS communications and resulting news articles have heavily emphasized the impact of unwinding on children and families. However, the unwinding process is also impacting many older adults and people with disabilities who must also renew their coverage for the first time in three years.

According to a NAHC analysis, in the 22 states where data is available on the specific populations, at least 76,630 older adults and people with disabilities lost Medicaid coverage. This represents approximately 5% of the disenrollments in these states; however, it likely undercounts the actual number of older adults and people with disabilities who were removed from the program. Most of the 22 states included in the sample do not specifically identify older adults and people with disabilities in their Medicaid unwinding data. Therefore, the calculations were based upon aggregate changes in enrollment for these populations, which does not account for routine growth in the programs.

The proportion of individuals in these categories disenrolled from the program were higher in those states that specifically broke out those groups for reporting. For example, data indicated that older adults and people with disabilities represented 11% of disenrollments in Virginia, 15% New Jersey, 8% in Missouri, and 9% in Massachusetts.

Medicaid termination is particularly impactful for older adults and people with disabilities, given that many of the long-term services and supports provided by the program are not available in Medicare or private insurance. Homecare providers can support individuals by ensuring that they are aware of the redetermination processes underway, know where to provide updated information, and make sure that all requested documentation is returned in a timely manner. For more information, visit the NAHC and United HealthCare joint renewal resource and webinar at: https://www.uhccommunityandstate.com/content/articles/an-all-hands-on-deck-approach-to-redeterminations