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Advocates, policy experts, and lawmakers are growing increasingly outraged as data and anecdotes emerging from states across the U.S. indicate that hundreds of thousands of people—including children and seniors—are being thrown off Medicaid for failing to submit paperwork on time and other bureaucratic reasons.

State figures obtained by the Associated Press show that at least 1.5 million people in roughly two dozen states have been removed from Medicaid since April, when state governments were given a green light by Congress and the Biden administration to resume eligibility checks that were halted during the coronavirus pandemic.

"Pausing disenrollment was a tremendous act of social welfare; restarting it is criminal," tweeted Timothy Faust, a single-payer advocate who helps people enroll in Medicaid.

"You have no idea how complicated it is to get an application together and how arbitrary the decisionmaking feels," Faust wrote Monday.

Eligibility checks come with paperwork and other requirements that are often confusing and difficult to navigate. The process is made even more difficult by the failure of some states to sufficiently inform Medicaid enrollees about the resumption of eligibility checks and the steps they must follow to keep their coverage.

As a result, a staggering number of people have lost coverage in recent months, with the impact heavily concentrated in a handful of states.

Republican-led Florida has kicked around 250,000 people off Medicaid since March. In more than half of those cases, people were removed for procedural reasons, not because they were deemed ineligible for the program due to income or other factors.

Elliot Haspel, an author and policy expert, lamented the lack of national media coverage of the Medicaid purge given the devastating consequences for vulnerable people who are losing coverage.

Local media outlets in Florida and elsewhere have elevated stories of individuals who have lost coverage due to red tape, including an 87-year-old woman who relies on the program for her home health aide and a seven-year-old child with leukemia.

"The ratio of impact to real people's lives to media coverage on this Medicaid red tape story is one of the most skewed in recent memory," Haspel wrote Monday. "This is a true scandal, and should be covered as such."

Some people have reported having their health coverage thrown into chaos by government errors, a common occurrence as understaffed state Medicaid systems work to redetermine eligibility for millions of residents.

The Associated Press on Monday highlighted the story of 28-year-old Jennifer Mojica, who "was told in April that she no longer qualified for Medicaid because Arkansas had incorrectly determined her income was above the limit."

"She got that resolved, but was then told her five-year-old son was being dropped from Medicaid because she had requested his cancellation—something that never happened, she said," the outlet reported. "Her son's coverage has been restored, but now Mojica says she's been told her husband no longer qualifies."

Arkansas, led by Republican Gov. Sarah Huckabee Sanders, has removed around 110,000 people from Medicaid since April, according to data compiled by the Kaiser Family Foundation (KFF).

Sanders has openly celebrated the speed with which Arkansas is stripping residents of coverage. The federal government has given states a little over a year to complete Medicaid eligibility checks, and Arkansas is working to complete the process in six months—the fastest pace in the nation.

The U.S. Health and Human Services Department, which is facing growing calls to intervene as states leave hundreds of thousands without coverage, has estimated that 15 million people could be removed from Medicaid by the time states are done with their eligibility checks.

In addition to the red-tape disenrollments, some people have been removed from Medicaid because their incomes are now too high to qualify for the program—meaning they'll have to seek coverage elsewhere, such as the Affordable Care Act (ACA) exchanges. Income limits for Medicaid are particularly strict in the ten Republican-led states that have opted against expanding Medicaid under the ACA.

As The Washington Post's Amy Goldstein recently warned, "Because those states tend to make only the extremely poor eligible for Medicaid, they will have many people who make too much to qualify for the government health insurance but not enough to reach the income needed to get federal subsidies to afford health plans sold on ACA marketplaces."

A KFF survey released last month showed that more than 40% of people with Medicaid as their only source of health coverage say they "wouldn’t know where to look for other coverage or would be uninsured" if they were kicked off the program.

"If we had Medicare for All," said Rep. Ro Khanna (D-Calif.), "this wouldn't be a problem."

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Jake Johnson is a staff writer for Common Dreams.

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