Research Finds Significant Racial Disparities in Medicaid Re-enrollment

Black and Hispanic Americans were twice as likely as white Americans to lose Medicaid last year because of an inability to complete renewal forms during a vast trimming of the program’s rolls, according to a study published on Monday in the journal JAMA Internal Medicine.

The findings from researchers at the Oregon Health & Science University, Harvard Medical School and Northwestern University are some of the first comprehensive data on race gathered after a pandemic-era policy that allowed Medicaid recipients to keep their coverage without regular eligibility checks ended last year.

More than 22 million low-income people have lost health care coverage at some point since April 2023, when the policy allowing continuous enrollment lapsed. The process of ending that policy — what federal and state officials have called “unwinding” — was one of the most drastic ruptures in the health safety net in a generation.

“Medicaid eligibility is complex, and then applying and keeping Medicaid coverage is a huge logistical barrier,” said Dr. Jane M. Zhu, an associate professor of medicine at the Oregon Health & Science University and one of the study’s authors. “What this analysis is showing is that these barriers have downstream spillover effects on particular communities.”

Researchers have found that increases in health insurance coverage across racial and ethnic groups from 2019 to 2022 were largely driven by Medicaid.

A provision in a coronavirus relief package passed by Congress in 2020 required states to keep recipients of the joint federal-state health insurance program for the poor continuously enrolled in exchange for additional federal funding.