Iowa's Medicaid enrollment cliff fell far further than projected

Iowa disenrolled nearly 250,000 Medicaid recipients last year, a rate almost 160% above projections, according to a new Urban Institute analysis.

Why it matters: Even brief gaps in insurance can disrupt care and worsen health outcomes — especially for children, whose "rapid development" makes them more vulnerable than adults, the study's authors write.

• Iowa children lost coverage at an even greater rate: about 280% above projections.

Catch up quick: States regularly review the eligibility of people enrolled in Medicaid based on income or other factors. But Congress put a hold on those checks during the pandemic.

• That pandemic-related safeguard ended in March last year, and states have since been re-assessing their Medicaid rolls for the first time in three years.

The big picture : At least 21 million Medicaid recipients were disenrolled as of this month nationwide according to KFF , an independent health policy research organization.

Zoom in: More than 53,000 fewer Iowa kids are on Medicaid than before the disenrollment process began, according to the Center for Children and Families at Georgetown University

• Iowa is one of 10 states with lower child enrollment in December than before the pandemic, according to the center's report .

State of play: Fewer people on Medicaid is a factor in record-high requests for humanitarian help, multiple metro health and food assistance networks have reported for months.

• The Des Moines Area Religious Council (DMARC) Food Pantry Network, for example, last month recorded the second-busiest month in its nearly 50-year history with more than 25,000 unique people served.

The intrigue: Most Medicaid disenrollments happen because of procedural reasons like failing to correctly fill out paperwork, per KFF.

What they're saying: A large number of Iowans are back to work since the pandemic and no longer need or qualify for Medicaid, Iowa Department of Health and Human Services spokesperson Alex Murphy said in a statement to Axios.

• Many people have transitioned to Marketplace or employer-sponsored health insurance, he said.

The bottom line: Iowa is one of eight states where disenrollment is more than 100% of the Urban Institute's projections.

• Only Oklahoma (189%) and Montana (180%) had higher rates.