By Sarah Whites-Koditschek
Huntsville/Madison County NAACP Branch, holds a sign
in support of the expansion of Medicaid in front of the
Alabama State House in January 2014. (AP Photo / Butch Dill)
An estimated 61,000 Alabamians could lose health care coverage through Medicaid as federal pandemic protections are rolled back this spring. The state will see the numbers of uninsured people rise by over 16 percent, according to a new report.
In Alabama, the number of people going without health insurance is expected to rise by about 61,000, up to an estimated 432,000 uninsured residents in total by June of 2024. The state is expected to drop people off Medicaid who no longer qualify this spring, as federal protections preventing states from dropping Medicaid recipients from the rolls expire. The projections are part of a report by the Robert Wood Johnson Foundation and the Urban Institute, which drew from data from the Centers for Medicaid and Medicare Services.
“An increasingly urgent question is what will happen to health coverage after the (declaration) expires and states resume normal eligibility determinations?” the report authors stated.
Nationwide, about 18 million people are estimated to lose Medicaid beginning in April if the U.S. does not extend the pandemic health emergency created in 2020 as a part of the Families First Coronavirus Response Act.
“An unprecedented number of people have enrolled in Medicaid since the pandemic began,” the report stated. The group found roughly 18 million extra people have joined Medicaid during COVID-19.
For some of those people now losing insurance due to job changes or a rise in income, it will be possible to get insurance through their employers. The study found an estimated 9.5 million people will likely gain insurance back through work. However, about 3.8 million more people nationwide will become uninsured once the protections expire, the groups estimate.
“The people most likely to churn in and out of Medicaid eligibility include young adults, workers with part-time jobs, and people with incomes close to eligibility cutoffs,” the report found.
In states like Alabama, which have not expanded Medicaid, more people are likely to fall through the cracks and lack insurance once they are dropped from the program. Many states have expanded Medicaid since the passage of the Affordable Care Act to cover people who earn too much to qualify for traditional Medicaid but too little to qualify for health plans through the marketplace because they do not earn 100 percent of the federal poverty level, about $18,310 for a family of two or $23,030 for a family of three. In Alabama, to qualify for Medicaid, a family of two must earn less than $3,300 a year and be a primary caregiver or $15,372 a year for children.
Alabama has an incentive to quickly remove people from Medicaid who no longer qualify as federal funds to support the emergency declaration will be withdrawn when it ends, according to the study.
For Alabamians who are eligible to shift to employer-based plans or to the federal marketplace because they no longer qualify through Medicaid due to an increase in earnings during the pandemic, their monthly health care premiums will likely rise, according to the report. Overall, however, the number of people on Medicaid is likely to remain similar to pre-pandemic levels, the report found.
