Nearly 500,000 Virginians in Medicaid have been disenrolled

State social services workers sign up residents for Medicaid at a resource fair in Richmond in 2018. (Ned Oliver/ Virginia Mercury)

Of the roughly 2 million Virginians who’d been enrolled in Medicaid before the COVID-19 pandemic, over 480,000 of them have been disenrolled as of this August.

Typically eligibility determinations are made annually, but they’d been on pause nationwide amid the pandemic due to federal policy. That’s changed over the past year in what’s colloquially referred to as “Medicaid Unwinding” as provisions of federal law have expired.

A top reason for disenrolling people from Medicaid is that they no longer meet the financial requirements to be eligible — such as income at or below 80% of federal poverty levels.

While the ineligibility data could point to higher incomes which can be a good thing for people, policy analysts at The Commonwealth Institute caution that is not always the case when it comes to health insurance coverage.

Financial disqualifications from Medicaid don’t always mean someone has health insurance otherwise, TCI policy director Freddy Mejia explained.

Examples could be someone having a combination of part time jobs tallying up to their overall income — which wouldn’t entail employer-sponsored insurance — or people might have a temporary spike in income through seasonal work that kicks them off eligibility for Medicaid.

There are also non-financial reasons to be removed, which can include procedural hiccups like not submitting proper paperwork for reenrollment on time .

“We’re seeing a lot of people come off Medicaid enrollment, but we don’t have a clue what is happening with them,” Mejia said. “Future data will take time to see who is uninsured or not after this.”

Medicaid is a state and federal program that provides insurance coverage to low-income people or people with disabilities. For some people, having Medicaid or even employer-offered insurance may not be enough. For instance, Virginia’s free clinics report an uptick in patients in recent years.

Some of these patients are dubbed “ALICE patients,” — or asset-limited, income-constrained, employed people.

Rufus Phillips, CEO of the Virginia Association of Free and Charitable Clinics, said the demographic was contributing to patient uptick even before the pandemic.

“The pinch is much greater on what we used to know as the middle class,” he said.

The clinics around the state have been a key point of healthcare access for some of Virginia’s poorest residents along with immigrant and refugee families. They are also a resource for people who are between jobs and insurance coverage — the “safety net to the safety net,” Phillips said.

Mejia noted how more uninsured people can continue to strain Virignia’s free clinics and Federally Qualified Health Centers who may need to serve larger populations than their resources will be able to handle.

In the meantime, there are still about 69,000 people who are still awaiting redetermination for Medicaid. A spokesperson for the Virginia Department of Medical Assistance Services said that number is a backlog of members that are about 3% of the “total unwinding cohort.”