The great Medicaid purge

The great Medicaid purge

States across the country will start reviewing Medicaid eligibility for the first time in three years on Saturday. While enrollment surged for the program during the pandemic as Congress gave states more money to pay claims and added safeguards to ensure that no one lost coverage, those protections expire on April 1. But nearly half of the 6.8 million Americans expected to lose their Medicaid coverage will still be eligible for the program, according to government estimates. A whopping 72% of children expected to lose their health coverage will still be eligible for programs. The Washington Post’s Catherine Rampell explains why eligible people will be terminated from Medicaid and how it exposes a much larger problem. 

The degree of government failure here should be considered scandalous. To be clear: These people are not losing insurance because their incomes rose, or they aged out of a given program. Rather, they’re losing coverage for pointless bureaucratic reasons. Maybe a letter got sent to the wrong address. Or a beneficiary had difficulty with a broken government website. Unfortunately, this red tape is the same reason why lots of eligible families get purged even in a normal, non-end-of-pandemic year. As aberrant as the current “Medicaid unwinding” might appear, it obscures a problem that has long ailed U.S. government programs at virtually all levels: how little federal and state policymakers have done to guarantee access to critical, promised safety-net benefits.

Louisiana plans to spend nearly $200 million over the next 15 months to help ensure that eligible people stay on the program.  


Four parishes rank in top 10 in population loss
Four Louisiana parishes were ranked in the top 10 nationally for population loss, according to new Census data released Thursday. The outmigration was centered around parishes that were struck by Hurricane Ida in 2021. St. John the Baptist Parish, Terrebonne Parish and Plaquemines Parish ranked two, three and four, respectively, while St. Charles ranked eighth. Nola.com Faimon A. Roberts III reports: 

St. John the Baptist lost 5.1%, Terrebonne 3.9%, Plaquemines 3.3% and St. Charles 2.7%. The estimates were limited to parishes and counties with a population greater than 20,000. Some of Louisiana’s largest metropolitan parishes also lost population. Jefferson Parish lost 8,045 residents, Orleans 7,314 and East Baton Rouge 3,109, according to the estimates. Lafayette Parish was one of the largest gainers, with 2,944 new residents. 

Stronger storms fueled by climate change are making Louisiana a riskier and more expensive place to live. Louisiana’s homeowners’ insurance crisis, combined with the looming increase in flood insurance rates, could crush the dream of homeownership in many parts of the state. It’s imperative that politicians up for reelection or seeking higher office this fall explain their solutions to address this existential crisis. 


How small rural towns can access IRA funding
The Inflation Reduction Act, the sweeping climate, tax and health care package that Congress passed over the summer, includes money for rural development and energy infrastructure. But competition for the federal funding is competitive, and many small towns often lack the resources needed to win these dollars. Harvest Public Media’s Eva Tesfaye explains what’s needed for small, rural communities to access IRA funding. 

“Honestly, what it requires is someone locally who just has a passion for their community and for this topic,” [Jigar Shah, Director of the Loan Programs Office at the U.S. Department of Energy] said. “When that person identifies themselves and they want to go deep, then we have all the resources to let them go deep, and then they need to start a conversation in the community.” … [Executive director of Climate Mayor Kate] Wright also said that collaboration is going to be critical. Towns can work with their state’s department of energy and department of transportation. “I think being able to work together and in partnership can create additional capacity that might not be there in a smaller under-resourced city.”


ARPA turns 2
The American Rescue Plan Act directed billions of dollars to help states and local governments provide critical services during the pandemic and offset revenue gaps. The expanded Child Tax Credit included in the law helped cut child poverty by 46%, and other funds were used to address housing, education, food assistance and other forms of relief. As most of the federal dollars have been disbursed to states, the Center on Budget and Policy Priorities’ Iris Hinh and Juliette Kimmins look back at ARPA two years later. 

To date, state and local lawmakers have budgeted billions in funding for public health projects, housing-related purposes, workforce support, small business support, and critical infrastructure investments. … Forty-six states, D.C., and all the territories invested in economic relief and development, with eight states appropriating one-fourth or more of their FRF allocations to date for economic development initiatives. … Forty-three states, D.C., and all the territories invested in economic security by providing housing, cash, and food assistance to help people afford the basics and to build longer-term stability. 

Louisiana has appropriated $1.6 billion (53.1%) of its $3 billion appropriation. Of its current total appropriations, the state has spent $898 million (56.1%) on capital construction, $490 million (30.6%) on unemployment insurance and $147 million (9.2%) on economic development. 


Number of the Day
72% –
Percentage of American children expected to lose their Medicaid or CHIP coverage who will still be eligible for those programs. States across the country will start reviewing Medicaid eligibility for the first time in three years on Saturday and many recipients are expected to lose coverage for bureaucratic reasons. (Source: U.S. Department of Health and Human Services)