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A provision in a 2020 coronavirus relief package prohibited states from kicking anyone off of Medicaid, regardless of whether or not they were still eligible. But that provision ended last month.

Initial data from some of the states that already started the process shows that thousands of people are falling through the cracks, losing coverage because of “procedural” problems.

This means that even though they may still qualify for Medicaid, they were kicked off coverage because the state didn’t know if they were eligible. Maybe they moved and the state couldn’t find them, or their income was reported incorrectly in the state database.

The Biden administration projected that about 15 million people will lose coverage, including nearly 7 million people who are expected to be dropped despite still being eligible because of administrative barriers like lost or incomplete paperwork.

States have a year to go through the once-routine process of sorting through Medicaid rolls, though some are moving much faster.


Advocates have warned of chaos even under the best circumstances, but especially if states move quickly and don’t put a lot of effort into figuring out if people are eligible.

Arkansas for instance is speeding through the redetermination process in only six months, citing cost concerns and the goal of Gov. Sarah Huckabee Sanders (R) to push people to “escape the trap of government dependency.” 

In the first month, about 73,000 people lost coverage in Arkansas, including about 27,000 children 17 and under. According to an analysis by the Georgetown University Center for Children and Families, approximately 80 percent of the terminations were for procedural reasons.

In Florida, more than half of the people who had their eligibility checked last month had their Medicaid coverage terminated.