Opinion | The Great Medicaid Purge begins

Other states have said they will follow. The entire purge, which is completely legal, will take place over a year.

What’s behind this mass disenrollment?

The proximate cause might seem reasonable: The covid-19 public health emergency is no longer forcing states to retain every Medicaid enrollee already on the books.

Early in the pandemic, as a condition of receiving additional federal funding, states were temporarily barred from kicking anyone off Medicaid. This was intended to guarantee more people access to medical care while the coronavirus crisis was raging. Better to err on the side of keeping people insured, lawmakers figured, lest any cash-strapped states find excuses to dump patients to save money. Or maybe states would terminate lots of beneficiaries by accident, amid the chaos of office closures.

Thanks to this federal policy change, Medicaid and CHIP rolls swelled, and the country’s uninsured rate fell to a record low last year. But as covid risks abated, all sorts of emergency safety-net measures, from extra food stamps to free covid vaccinations, have been phased out. Everyone knew that, at some point, the relaxed Medicaid regulations would likely sunset, too.

That sunset begins this Saturday. As a result, a lot of Americans are about to fall through the cracks of our haphazard health-insurance system, and become uninsured altogether.

In fact, many will become uninsured even if they still legally qualify for Medicaid!

According to government estimates, nearly half the people expected to get purged from Medicaid (6.8 million) will still be eligible for Medicaid. Among children, the share is even higher: 72 percent of children expected to lose their Medicaid or CHIP coverage will technically still be eligible for Medicaid or CHIP.

The degree of government failure here should be considered scandalous. To be clear: These people are not losing insurance because their incomes rose, or they aged out of a given program. Rather, they’re losing coverage for pointless bureaucratic reasons. Maybe a letter got sent to the wrong address. Or a beneficiary had difficulty with a broken government website.

Unfortunately, this red tape is the same reason why lots of eligible families get purged even in a normal, non-end-of-pandemic year. As aberrant as the current “Medicaid unwinding” might appear, it obscures a problem that has long ailed U.S. government programs at virtually all levels: how little federal and state policymakers have done to guarantee access to critical, promised safety-net benefits.

Depending on the state, proving and re-proving eligibility for Medicaid (or food stamps, or other programs) can be somewhere between cumbersome and impossible. In some parts of the country, this is deliberate:…