Unwinding of PHE and Effects on Net Medicaid Enrollment in Missouri
The state of Missouri is reporting the impacts of the unwinding of the PHE in Missouri, but full net impacts depend on churning between categories
A previous Substack post by this author summarized the impacts of three months of the “unwinding” of the Public Health Emergency (PHE) in Missouri on Medicaid enrollees. The unwinding began at the end of June and the state is releasing data is releasing data on the outcomes of those recertifications in a public dashboard.
While the unwinding is happening, Missouri residents continue to enroll in Medicaid (as they always do), and it is possible that some who lost coverage in the unwinding process are signing up for Medicaid again in the same category they were covered in before, or perhaps in another category. For example, a recipient who was enrolled during the PHE as a custodial parent, who became ineligible may be eligible under the rules for the Medicaid expansion.
The so-called “Caseload Counter” published by the state and “Monthly Management Report” publishes data that gives evidence about what the NET EFFECT of disenrollment, but also enrollment in Medicaid. This post and the Table below summarizes the changes from June to August 2023 in Missouri.
In summary:
net MOHealthNET enrollment dropped 30,664 from June to August 2023 (see Table).
over half (17,178, 56%) of the drop in MOHealthNET enrollment was in the “children” category (those under age 18), while 18% (5,448) of the drop was persons with disabilities, 14% (4,254) was in the adult expansion category and 11% (3,526) in the custodial parents category.
In Missouri, children can enroll in Medicaid through CHIP or not through CHIP (based on their income) or a range of other smaller programs). The enrollment data show that in the June to August period CHIP enrollment grew by 2,079 persons, while net enrollment in the MOHealthNET for families or MOHealthNET for Kids categories dropped by 19,248. This could reflect that some individuals were in families that saw their incomes rise, so the parents were no longer eligible, but the children were still eligible under the CHIP program.
