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Providers likely to experience increase in Medicaid beneficiaries

Crystal Yednak Senior Manager, Health Research Institute, PwC US June 18, 2020

Early Medicaid enrollment figures from states suggest a shift toward Medicaid, with some states already registering double digit-increases since the start of the pandemic, according to an HRI analysis of state data.

Of 16 states reporting May or June enrollment data, the majority logged a 5% increase or more in enrollment from February. Kentucky, Minnesota and Missouri have reported increases of more than 10%.

The numbers are not unexpected, with more than 45 million initial jobless claims filed in 13 weeks because of the pandemic, leading many workers to lose employer-sponsored health insurance.

A Kaiser Family Foundation (KFF) analysis estimated that following a job loss, 19.2 million people would likely have access to employer-sponsored insurance through another family member, but that as of May 2, nearly 27 million people would find themselves newly uninsured after a job loss. Of those newly uninsured people, Kaiser estimated that 12.7 million may qualify for Medicaid and an additional 8.4 million may be eligible for subsidies for plans available through the Affordable Care Act exchanges.

A lag in the loss of coverage is expected, with some Americans retaining some benefits through the end of the year. But by January 2021, the share of people with job losses qualifying for Medicaid is expected to grow by a third to 16.8 million, according to the KFF.

HRI impact analysis

While insurers may experience declines in commercial enrollment, they may see continued growth in Medicaid lines of business.

The Families First Coronavirus Response Act prohibited states from disenrolling members during the public health emergency, and federal and state actions also removed barriers to enrollment in response to COVID-19. Both are contributing to the increased enrollment, but with states seeing revenues crater because of the economic impact of the pandemic, the swelling Medicaid costs will contribute to budget crises.

The National Association of Medicaid Directors warned in late May that a surge in Medicaid enrollment would be coming, even though a bit delayed, pointing out that it took a year during the Great Recession for Medicaid enrollment to peak. The reasons are varied: People put off going into medical offices because of COVID-19 and so may not be prompted to enroll. Some who lose jobs may find employer-sponsored coverage lasting through the end of the month, delaying pursuit of other options.

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Contact us

Trine K. Tsouderos

HRI Regulatory Center Leader, PwC US

Tel: +1 (312) 241 3824

Crystal Yednak

Senior Manager, Health Research Institute, PwC US

Erin McCallister

Senior Manager, Health Research Institute, PwC US

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