Pearl River       One of the major successes of the Biden administration’s handling of the pandemic was the provision in the Covid relief legislation and appropriations in 2020 that required states to maintain Medicaid enrollment under the Affordable Care Act as the quid pro quo to receive additional funding.  According to government figures, over 90 million people were enrolled in Medicaid and the Children’s Health Insurance Program (CHIPs) by 2023, as the funding expired.  Those numbers add up to an increase of over 20 million recipients from before the pandemic.  In percentage terms, that would be almost 25% of the American populations.  Breaking down this participation, about “half of Medicaid enrollees are Black or Hispanic, and around 40% are white,” according to a New York Times’ report.

That’s the good news, because according to the same shocking report, along with work done by other university-based researchers and other nonprofits, all of the numbers became worse from those high points to where we are now, once the additional funding ended and the states were once again left to their own devices and more lax and punitive policies.  Academic researchers from Oregon, Northwestern, and Harvard have found that “over 22 million low-income people have lost health care coverage at some point since April 2023, when the policy allowing continuous enrollment lapsed.”  Georgetown University researchers found that since May 2023, 13 million, including 5 million children, seem to have permanently dropped off the roles.

What happened to turn a generational increase into a generational decrease?  The answer seems to be in the devilish details that are involved in the complex Medicaid application and renewal process.  A nonprofit found that “…about 70 percent of those who lost coverage might have still been eligible and fell out of Medicaid for bureaucratic reasons, such as failing to return paperwork in time….”  This “gotcha” system also meant that the losses were disproportionately among Black and Hispanic families, who were “…twice as likely as white Americans to lose Medicaid last year because of an inability to complete renewal forms….”

In my view, this is a “life and death” scandal.  How as a society have we allowed this to happen?   Why are we not holding people, governments, and politicians at every level accountable?

Part of this lies in the digital divide, where too many states are demanding forms be filled out and submitted via the internet.  Don’t tell me that the fact that more people have access via their phones is the answer.  Anyone who has ever had to fill out a form on a smartphone knows how difficult that is.  I’ll never forget trying to change planes in London’s Heathrow during the pandemic and having United not accept my Covid shot record.  I had to exit the airport and fill out a form on my phone to get a new certification. I wasn’t alone, there were many in the same predicament.  It took me more than a half-hour to finally get the form accepted and completed on my phone and transmitted, and that took help and then walking me through, so I could make the plane home.  I’m still in recovery from the experience.  I’m not a coder or hacker, but that was a mountain to climb, so I can fully appreciate how impossible reenrollment might be for many families, no matter how desperate for health coverage.

The forms are too damn complicated.  We need to fix that.  In the meantime, the other problem is not enough help and outreach.  States and the federal government knew this was going to be a problem, but to the best of my knowledge, little was done.  I also fully believe, from the way many red states handle welfare for eligible families, that many of them were likely to be deliberately making it harder and hoping that fewer people enrolled for the little they pay in the match with the federal government.

We have to do better than this.  We should be ashamed at every level for allowing this kind of bureaucratic failure that leaves blood on all of our hands and deaths on our consciences.