Final, Preliminary Unwinding Data for Missouri Medicaid: almost 356,000 lose coverage
Over twelve months, 63% have retained coverage, 26% have lost coverage. Nearly half of those losing coverage are children.
Jun 11, 2024.
The state of Missouri has released the twelth month of data on the unwinding of the Medicaid public health emergency (PHE) in a public dashboard, covering the recertifications of nearly persons on the Medicaid rolls. The state releases data on the unwinding each month. But for this analysis Center for Advancing Health Services Policy and Economics Research at Washington University in St. Louis has looked at the cumulative totals over the entire ten months of the unwinding of Missouri to draw conclusions.
Nationwide Medicaid enrollment rose to a record high during the pandemic, and in Missouri the enrollment also rose to over 1.5 million at its peak before the unwinding, a record.
Over the 12 months covering June 2023 through May 2024, the State of Missouri reviewed 1.38 million cases from June 2023 to March 2024, although the posted data are preliminary (because over 160,000 cases are still pending). Of those reviewed over 865,000 persons retained coverage (63%), but 355,813 have lost coverage (26%), including 167,803 children. Almost 162,000 cases remain pending (12%).
Although almost 356,000 lost coverage due to the unwinding, net Medicaid enrollment in Missouri has declined 212,203 so far, from 1.52 million in June 2023 to 1.3 million in May 2024. The net changes in Medicaid enrollment reflect people who are disenrolled from Medicaid due to the unwinding, new people who enroll onto the program, and people who reenroll on Medicaid following disenrollment referred to as “churn.”
The numbers for Missouri can be compared to other states using, for example, the Kaiser Family Foundation’s unwinding website, which is being continuously updated. Nationwide over almost 23 million Medicaid enrollees have been disenrolled and almost 50 million have had their coverage renewed, as of June 4 2024.
Some major points about Missouri’s unwinding:
From June 2023 to May 2024, almost 1.4 million (1,382,698) Medicaid cases were reviewed in Missouri. The state’s plan was to review the total set of enrollees over a 12-month period.
Over the twelve months, 63% (865,387) of recipients have been determined still eligible for Medicaid, while 26% (355,813) have lost coverage (been declared ineligible or lost coverage through a procedural determination). Another 161,498 (12%) are pending review.
Of those losing coverage over the ten months, 79% lost coverage for a “procedural determination” according to the state, which can be due to a range of reasons, while 21% lost coverage because they were reviewed and determined no longer eligible for the program. High “procedural determinations” is a metric being used widely to measure how states are doing (see Kaiser’s analysis) with their Medicaid redeterminations.
Of the total persons losing coverage so far over ten months, 47% (167,803) were children, 35% (125,495) were expansion adults, with the rest in other categories (see chart): the disabled, custodial parents, or the elderly.
At the end of twelve months, over 161,000 cases remained pending, dating back to when the unwinding began in June 2023. Of the pending cases, 58% of the pending applications were children and 28% were expansion adults, 11% were custodial parents with the rest being in other categories (see Chart).
The process of recertifying enrollment in Medicaid, which generally had been done on an annual basis before the COVID pandemic, was paused during the Public Health Emergency (PHE) by federal law in early 2020. This meant that those enrolled in Medicaid during that period were not disenrolled. Federal law passed at the end of 2022 called for an end to the PHE, and a renewal of the recertification process, commonly called the “unwinding” of the pandemic as it is affecting Medicaid. The state also reported these data by law to the Centers for Medicare and Medicaid Services (CMS).
