When the COVID pandemic hit, the Biden administration declared a public health emergency which, among other things, extended Medicaid coverage to millions of people. For the vast majority of them, that coverage is a lifeline. As of now, the public health emergency could end as early as mid July. What happens to people with Medicaid then?
The Biden administration needs to act thoughtfully and deliberately before declaring an end to the public health emergency. Since it was declared, Medicaid enrollment is up 12 percent and 25 percent of Americans now get their coverage through Medicaid. Taking Medicaid away from them because they are no longer eligible will have dire consequences.
With the end of the public health emergency and the federal Medicaid funding that goes with it, as many as 15 million low and middle-income Americans could end up losing their health insurance. As of now, states are forbidden from kicking people off of Medicaid and have received additional funds to cover Medicaid’s cost. But, states will need to ensure all Medicaid enrollees remain eligible once the emergency is over.
Many people who should have Medicaid coverage could lose it. A lot of people with Medicaid who remain eligible for Medicaid might not have the ability to undertake their state’s complex renewal application process. Other people with Medicaid might no longer qualify because their income is a little too high, or they might have moved to another state. Many of them likely have no clue that their coverage could end once the public health emergency ends and will only find out when they are told by their doctor’s office, their hospital or their pharmacy.
As it is, the uninsured no longer have access to free Covid-19 testing and treatment. That protection ended last month. There are no funds to pay for it. Free vaccines are also about to end.
It is not unreasonable for the Biden administration to end mask mandates and the like, as Covid’s threat to the public health appears to be waning. But, ending Medicaid protections is another story. Covid-19 has not gone away. Without insurance, many Americans will be hard-pressed to afford needed care, be it for Covid or something else.
This year, people who lose Medicaid can still enroll in a state health insurance exchange plan. Because Congressional funding of Affordable Care Act subsidies for people with low and middle incomes lasts through the end of this year, their insurance premiums will cost very little, if anything. But, in 2023, they will be at risk of being uninsured again.
Our dysfunctional fragmented and costly health care system affords few among us a way to address a public health emergency, let alone a complex disease. Costs are just too high, even with insurance. As a start, the Biden administration should extend Medicaid protections at least through the end of the year, even if it ends other protections that came with the declaration of a public health emergency.
And, if it wants to ensure that Americans are prepared for the next public health emergency or simply to safeguard people’s health and well-being, Congress should pass legislation that guarantees health care for all; it should pass Medicare for all.
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