Columbus, OH – On Monday, The Buckeye Institute released a new policy report, Medicaid: Why and How States Must Review Eligibility, that offers recommendations on how states should approach the Medicaid redetermination process that is required now that the federal Covid-19 public health emergency is over.

“Under temporary pandemic-era rules, the federal government told states you can’t remove anyone from your Medicaid rolls,” said Rea S. Hederman Jr., executive director of the Economic Research Center and vice president of policy at The Buckeye Institute and the author of the report. “The result, an estimated 9.5 million people who are ineligible for Medicaid are receiving benefits and draining $80 billion in taxpayer dollars from those in need.” 

When the federal emergency ended in May 2023, there was a cut in federal Medicaid funding, and there will be another cut in October. To avoid severe fiscal consequences, states must perform an arduous redetermination process to ensure benefits go to people eligible for the program. In his paper, Hederman offers three practical approaches states should adopt to ensure only people who qualify for Medicaid receive benefits. 

• States should automate eligibility reviews that are faster and can flag cases that need a more detailed review. Automated reviews would free Medicaid case workers to give more time and attention to complicated case reviews.
• States should prioritize Medicaid redeterminations and set prompt but reasonable review deadlines to ensure taxpayers’ money is well spent.
• States should establish a fast, transparent, easy-to-understand process for handling eligibility disputes and appeals. The process should be centralized so that the appellate process is efficient and avoids unnecessary lawsuits.

Hederman continued, “By adopting this approach, states can conduct efficient eligibility reviews, avoid significant budgetary shortfalls, and ensure that only people eligible for Medicaid receive benefits.”

# # #