Greetings—

As Congress continues to consider changes to Medicaid through the budget reconciliation process, Urban Institute researchers examine the impact of two proposed changes: how more frequent redeterminations for Medicaid expansion eligibility would affect enrollees and how mandated federal work requirements would affect parents and children.

The researchers find:

Increasing the frequency of mandatory eligibility checks for expansion enrollees to every six months would increase administrative burdens and reduce access to care. Many Medicaid coverage losses at redetermination are due to procedural challenges, not a change in eligibility. Therefore, increased redeterminations would create more opportunities for missing mail, higher burdens of completing paperwork, and a greater chance for losing coverage despite remaining eligible.
More frequent redeterminations would burden states, health plans, and providers. As eligible people are disenrolled and re-enrolled, administrative costs would grow for both state agencies and the federal treasury. Health plans would need to handle more paperwork, and health care providers would have to verify coverage more often.
Losing coverage under Medicaid work requirements would lead to worse health and financial outcomes for adults, which in turn would adversely harm children. Even if custodial parents are intended to be exempt from work requirements, many still could lose coverage because of misinformation, system errors, and administrative barriers.
Medicaid work requirements would also undermine the health care infrastructure. Adverse effects would likely extend to states’ economies and health care providers, including hospitals, since treating more patients without insurance would lead to greater levels of uncompensated care.

Throughout the reconciliation process, Urban experts are examining how proposed changes to Medicaid would impact health care coverage and spending. Visit the webpage to explore current findings, and subscribe to our updates to receive the latest health care research.

If you have questions for the research team, please reply to this email.

Thanks,