The share of the U.S. population without health insurance fell to an all-time low of 7.7% in the first quarter of 2023, according to new data from the National Center for Health Statistics. The record low — which translates to more than 25 million uninsured people — probably won’t last for long, though, as states continue to remove millions of beneficiaries from their Medicaid programs following the official end of the Covid-19 pandemic.
The drop in the uninsured rate, which had fallen from a peak of 18% in 2013 to a range near 10% following the enactment of the Affordable Care Act, was directly related to the pandemic. Starting in 2020, in an effort to protect more of the population from Covid-19, the federal government provided additional funding to the states to expand Medicaid coverage while forbidding them from removing beneficiaries regardless of eligibility. Before the pandemic, significant numbers of Medicaid beneficiaries were routinely removed from the program as their incomes increased or they failed to provide the required paperwork to maintain coverage, but that churn was suspended for more than three years.
As a result, Medicaid enrollment rose by more than 30%, with about 93 million people — or more than one in four Americans — covered by the program by the beginning of this year.
With the end of the pandemic, states have started to remove beneficiaries once again, with some states moving more aggressively than others, raising fresh concerns about people losing coverage for procedural reasons. According to KFF, a health policy group tracking disenrollment data, some 3.8 million people have been removed from state-level Medicaid programs since the process started in April, with the majority losing coverage for reasons such as failing to complete paperwork or return forms rather than being determined to be ineligible through a review process.
KFF estimates that as many as 24 million people could lose their Medicaid coverage once the review process at the state level is complete. Some will find coverage through employment or family members, but millions will likely go without coverage, pushing the uninsured rate back toward its pre-pandemic levels.