Rolling Stone: More People Than Ever Use Medicaid to Pay for Healthcare

A record number of Americans are relying on for healthcare coverage during the pandemic. Nearly 74 million people are currently enrolled on Medicaid, the highest number participating in the program on record, according to a report by the Centers for Medicare and Medicaid Services (CMS). During the pandemic, from February 2020 to January 2021, an additional 9.7 million individuals enrolled in Medicaid, increasing the size of the program by nearly 14 percent.

In an interview with the Washington Post's Amy Goldstein, CMS Administrator Chiquita Brooks-LaSure said that Medicaid has been a "lifeline" for many Americans. "We've really seen how important Medicaid is to ensuring the overall health of our country and have seen this through the pandemic," she said.

The reason so many are enrolled is because of a law change passed in the first coronavirus relief bill. As part of the bill, states received additional funds from the federal government to cover predicted increased Medicaid costs, and in return, the states did not run eligibility checks on enrollees. Usually, if a family that qualified for Medicaid gained more income, the state would remove them from the program if that income went above the eligibility threshold.

But because of the relief bill, those eligibility checks are on hold until after the government ends the coronavirus public health emergency, so more people are staying enrolled. Thus far the Biden administration has signaled the emergency will continue through the end of the year, if not longer.

"What we are seeing now is the high-water mark for Medicaid enrollment," Massey Whorley, a Medicaid expert with Avalere, told Modern Healthcare.

Complicating matters, once the public health emergency ends, many people currently enrolled may become suddenly ineligible for Medicaid. Some with higher income may now qualify for subsidized private insurance through the Affordable Care Act (ACA) marketplace. Some may be booted from Medicaid because of new requirements or restrictions passed by the states. Others may fall into what is called the "Medicaid coverage gap," meaning their income is too high to qualify for Medicaid through their state but is still below the poverty line, the minimum income requirement to qualify for an ACA plan.

Rep. Lloyd Doggett (D-Texas) has introduced a bill last week, the COVER Now Act, which would close that gap. If passed, it would allow local governments — counties, cities, and municipalities — to expand Medicaid coverage to people in their communities, even if the state government has blocked federal Medicaid expansion.

"For many of our most disadvantaged citizens this bill offers a pathway to access a family physician, necessary medicine, and other essential coverage that thirteen states continue to deny," Doggett said in a statement. "The COVER Now Act empowers local leaders to assure that the obstructionists at the top can no longer harm the most at-risk living at the bottom."