Millions of Americans to Be Removed From Medicaid Rolls as COVID Emergency Ends

In starting the month of April, millions of Americans who had enrolled in Medicaid despite being ineligible will be removed from the program with the ending of the federal government’s COVID-19 national emergency.

The Department of Health and Human Services (HHS) was allowed, with the national emergency declaration, signed by former President Donald Trump in March 2020, to waive or modify some requirements for enrollment in Medicaid.

On March 29, 68–23 U.S. Senate voted to terminate the emergency declaration. There were 21 Democrats who voted in favor of the termination.

Although the bill had been opposed by the current President Joe Biden earlier, according to reports, he will not veto it.

In a Jan. 30 Statement of Administration Policy (pdf), the Biden administration announced its plans to extend the COVID-19 public health emergency to May 11. The rationale was that an “abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system—for states, for hospitals and doctors’ offices and, most importantly, for tens of millions of Americans.”

On Jan. 31, the House voted 220-210 to end the public health emergency—a separate declaration from the national emergency—that was enacted three years earlier on Jan. 31, 2020.

‘Medicaid Handcuffs’

Hayden Dublois, the director of data and analytics at the Foundation for Government Accountability (FGA), said that the federal government gave states additional Medicaid funding in the pandemic.

The states were prohibited from removing anyone from their Medicaid rolls, even if they became ineligible for the program for the duration of the Public Health Emergency, in exchange for this, Dublois told The Epoch Times.

“Remember, at the beginning of the pandemic we had those unemployment bonuses, the $600 weekly bonus, and that income was disregarded from being counted toward Medicaid eligibility,” Dublois recalled. “So you had people making well above the poverty level who were on Medicaid and continued to be on Medicaid long after they became ineligible because of these COVID-era restrictions.”

However, Dublois said states were not allowed to question an individual’s status or to allow their rolls to be scrutinized, restrictions he and others at the FGA described as “the Medicaid Handcuffs.”

“In December of 2022 Congress passed the Consolidated Appropriations Act, which said we can start removing these handcuffs and states can start removing people from their Medicaid rolls at the beginning of April, and that’s what we’re starting to see,” said Dublois.

“States are reasserting control over their Medicaid programs because this has cost them a tremendous amount of money. We’re talking hundreds of billions of dollars between the federally enhanced Medicaid funding and the fact that, for every person on the program that is ineligible, that costs state and federal taxpayers additional money. That takes away money from individuals who truly need Medicaid, such as the elderly and those with disabilities.”

Rather than decrying the removal of these individuals from the program, Dublois insists it’s a positive development.

“We should be celebrating the fact that states have regained control of their Medicaid programs and can remove these people who are no longer eligible. Now they can divert that money to the most vulnerable, those in extreme poverty, and those who have an intellectual, developmental, or physical disability. Those are the people in need. Those are the people the Medicaid program was created for. That’s where we need to be getting this back to.”

‘Fraud by Design’

When asked where the abuse of the Medicaid program started through “Obamacare” or the COVID public emergency, Dublois was direct.

“Medicaid fraud, waste, and abuse have been around for a long time,” he explained, saying “Obamacare essentially hit the accelerator.”

Dublois further noted that the Centers for Medicare and Medicaid Service (CMS) releases a yearly analysis of improper Medicaid payments.

“Right now, it’s roughly 1 out of every 5 dollars going to Medicaid is improperly spent,” he said. “That’s through blatant fraud, administrative errors, providers over-billing.”

For example, CMS confirmed that improper Medicaid payments amount to more than $80 billion annually—more than five times higher than they were just before Medicaid expansion began.

In an audit conducted over the period of October 2014 to March 2015, the HHS Office of the Inspector General found that New York made an estimated $26.2 million worth of improper payments to 47,271 ineligible individuals who signed up for Medicaid via former President Barack Obama’s Medicaid expansion (pdf).

During the same audit period, Kentucky made an estimated $105 million worth of improper payments to 34,593 potentially ineligible individuals (pdf), Ohio made an estimated $823.9 million worth of improper payments (federal share only) to 293,998 ineligible or potentially ineligible individuals (pdf), and California made a staggering $1.15 billion worth of improper payments to 455,133 ineligible or potentially ineligible individuals (pdf).

“None of these include the post-COVID Medicaid ineligible issues,” Dublois noted. “This is all on top of that.”

In all, Deblois estimated that between $20 million and $25 million has been paid to unqualified individuals through Medicaid since the beginning of the COVID-19 national emergency.

“It’s an astonishing amount when you consider that there are around 100 million people on the program,” he said. “So we’re talking about somewhere between a fifth and a quarter of the entire Medicaid programs consists of people who aren’t eligible. Think about that.”

Moreover, Dublois believes this was intentional.

“We term it as ‘fraud by design,'” he said. “When you look at state Medicaid programs, many states will accept self-attestation of an individual’s income. They take people’s word for their reported income and will not conduct any pre- or post-enrollment verification. There are components of Medicaid that have been woefully inadequate and that inadequacy in terms of no safeguards or cross-c