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Half a million children, individuals regain Medicaid coverage following HHS action

September 21, 2023

The U.S. Department of Health and Human Services (HHS) announced half a million children and families will regain their Medicaid and Children’s Health Insurance Program (CHIP) coverage after initially losing it during the “unwinding” process.

During a briefing Thursday afternoon, HHS officials said a “system glitch” inadvertently dropped thousands of eligible individuals from coverage. In addition to the 500,000 children and individuals who regained coverage after being improperly disenrolled, officials say many more are expected to be protected from improper disenrollments going forward.

“Thanks to swift action by HHS, nearly half a million individuals, including children, will have their coverage reinstated, and many more will be protected going forward,” HHS Secretary Xavier Becerra, J.D., said in a statement. “We will continue to work with states for as long as needed to help prevent anyone eligible for Medicaid or CHIP coverage from being disenrolled.”

At the end of the COVID-19 public health emergency, states could begin disenrolling individuals who no longer are eligible for Medicaid or CHIP coverage, or who lost coverage for procedural reasons, such as not returning required paperwork.

Months before the unwinding process began, the AAP launched advocacy and education efforts to ensure children would not lose health care coverage inappropriately or experience disruptions in health care. The AAP also provided resources at to help AAP members and chapters prevent children from losing affordable health care coverage.

Many states have an auto-renewal process, which uses information available through reliable databases to determine whether people are still eligible for Medicaid or CHIP. The Centers for Medicare & Medicaid Services (CMS) said many state eligibility systems were programmed incorrectly and conducted auto-renewals at the family level instead of the individual level, which may disenroll eligible children inadvertently.

“We asked states to give us their best ballpark estimate of people impacted,” CMS Deputy Administrator and Director Daniel Tsai said. “We don’t know exactly how many of those (500,000) are kids, but we do know kids will be a significant portion.”

Adult eligibility requirements are different than those for children. If a parent is not eligible for coverage but a child is, a procedural disenrollment may occur, Tsai said.

“We want the reinstatements to happen ASAP,” he said. “Part of the intense work that we’re doing with each of the states is to make sure that can happen as quickly as possible. There are a number of states who either have already reinstated or we anticipate are going to have reinstatements in place also in the course of this month, as well as being able to pause everything before the next set of disenrollments.”

According to Tsai, 30 states/territories indicated they had such an issue. As a result, CMS is requiring them to pause procedural disenrollments for impacted people unless they could ensure eligible people are not disenrolled improperly.

In August, the CMS sent a letter to all states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands requiring them to determine and report whether they have a system issue that inappropriately disenrolls children and families, even when the state had information indicating they remained eligible for Medicaid and CHIP coverage.

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