Nevada to resume procedural Medicaid disenrollments in January

Nevada Democratic Rep. Steven Horsford in his capacity as chair of the Congressional Black Caucus joined with national civil rights and health equity organizations to call on states to stop disenrolling people from Medicaid for procedural reasons this week.

Medicaid “unwinding” began in June in Nevada with the end of pandemic-era requirements that states continue coverage for people enrolled in Medicaid without requalification. In the six months since, Nevada had the nation’s highest procedural termination rate, according to the report that used data from health policy research organization KFF.

The Centers for Medicare & Medicaid Services (CMS) required Nevada and a majority of other states to pause disenrollment because of what they described as a “state systems issue” that led to “inappropriately disenrolling children and other enrollees, even when the state had information indicating the person remained eligible.”

Nevada plans to resume disenrollment for procedural causes in January for people who received requalification packets in November, said Kristle Muessle, the public information officer for the Division of Welfare and Supportive Services (DWSS) at the Nevada Department of Health and Human Services.

Horsford, along with representatives from several groups, including the NAACP,  Protect Our Care, the National Council of Urban Indian Health, and the Southern Poverty Law Center Action Fund, called for states to put on hold disenrollments for people on Medicaid for procedural causes like paperwork during a joint press call.

The coalition of groups is “calling for states to significantly cut rates of procedural terminations by renewing eligible families’ coverage and placing terminations on hold where possible, and by ensuring that beneficiaries have the necessary tools to complete their paperwork needed to determine their eligibility,” Horsford said in a statement.

Horsford’s office did not respond to requests for comment on the state’s plan to resume procedural disenrollments.

In response to the call from the groups to halt disenrollment, DWSS stated via email that it remains committed to covering all eligible Nevadans in compliance with federal laws and regulations.

In September, the state reinstated coverage for 114,000 Nevadans who had been disenrolled for procedural reasons. Those individuals who had their Medicaid reinstated in September will be enrolled for another 12 months and not need to go through the requalifying process first, Muessle said. 

The presentation Horsford participated in this week was accompanied by a report documenting that communities of color were “needlessly disenrolled from critical health care coverage because of missed paperwork, creating an avoidable civil rights and health equity disaster.”

Someone living in a state with high rates of procedural termination is more than four times more likely to lose Medicaid for paperwork reasons than in states that have lower procedural rates, according to the report.

The report noted that the states with these highest termination rates invested less in their basic Medicaid infrastructure — causing long wait times for calls and higher rates of those calls being dropped. In Nevada, the average wait time is 31 minutes, and 56% of calls are dropped before they connect to someone, according to state data. 

Over half of the families terminated from Medicaid come from communities of color, including 2.3 million Latino families, 1.8 million Black families, 400,000 Asian American, Native Hawaiian, and Pacific Islander families, and over 400,00 Native American families, according to the report.

Few states collect demographic data for disenrollments, but the proportion of people of color among those terminated is generally comparable to their overall representation among Medicaid recipients, according to the report. 

Nevada does keep demographic data. That national trend holds for Black, Native American, and white households in the state. However, nearly all Native Americans were disenrolled in the state — while they represent 1.3% of the Medicaid population, they were disenrolled at 1.1% in Nevada from according to state data. Two groups that disenrolled at higher rates than their Medicaid population are Hispanics which represent about 36% of the Medicaid population but were disenrolled at 42% and Asian-American/Pacific Islander which represents  6.7% of the Medicaid population, but was disenrolled at 7.8%.

“We cannot afford to roll back the hard-fought progress we have made on Medicaid, which has helped to narrow racial disparities in health coverage and provide much-needed access to life-saving care in communities of color,” Horsford said during the group’s video presentation.