March 29, 2023
Health centers are preparing for millions of patients to lose health insurance since the pandemic-era Medicaid continuous coverage rule expired on March 31st. The rule required state Medicaid agencies to provide enrollees with continuous coverage in exchange for increased federal funding. When the rule expires, state Medicaid agencies will redetermine enrollees’ eligibility for the first time in nearly three years. Estimates show that 17% of Medicaid enrollees, or nearly 15 million people, will lose coverage due to ineligibility or administrative churning.
Patients who lose Medicaid coverage can still access care at health centers, who treat everyone who seeks care regardless of their ability to pay. As millions of health center patients become uninsured, centers will face shrinking Medicaid revenue and increased costs from caring for more uninsured patients.
NACHC surveyed 420 health centers from all 50 states and US territories to understand the severity of financial and operational strain that may result from millions of patients becoming uninsured. Results reveal that Medicaid redeterminations could severely impact operations at some health centers and could disrupt patient care. Federal funding is more important than ever as health centers navigate redeterminations and continue to provide affordable care to the nations uninsured.
Key Findings
- Over a fourth (28%) of health centers surveyed estimate that 15% or more of patients enrolled in Medicaid will lose coverage during redetermination. Over half (58%) of health centers surveyed estimate that at least 10% of patients enrolled in Medicaid will lose coverage.
- 72% of health centers surveyed say that patients undergoing treatment for chronic conditions will be among those who lose Medicaid coverage.
- Over half of respondents anticipate having to reduce staffing and retention efforts and scale back some services due to financial and operational strain.
- Patients will feel the impact of unwinding-related strain on health center operations.
- 62% of respondents expect patients to face an increased waiting period for appointments, and
- 42% say patients may lose access to some clinical services if health centers are forced to make cuts due to financial strain.
- 75% of health centers surveyed said that increased funding for outreach and enrollment assistance would smooth the redetermination process and minimize coverage gaps for health center patients.
