GAO Releases Report on Medicaid Disenrollments During Unwinding

On June 24, the Government Accountability Office (GAO) released a report on Medicaid and Children’s Health Insurance: Disenrollments After COVID-19 Varied Across States and Populations. The report shows that, of the 89 million completed redeterminations by states, about 27 million individuals—or one-third—were disenrolled during the first 18 months of the unwinding process. Enrollment nationwide was around 79 million as of October 2024, which was about ten percent higher than pre-pandemic levels.

The report utilized data which included unwinding redeterminations completed from March 2023 through September 2024. Data revealed that there was significant variation across states in the percentage of individuals disenrolled during the unwinding process. To better understand the state-by-state variations, the report also reviewed data, documents, and interviews with Medicaid officials from five states: Arizona, Maryland, Montana, New York, and Wisconsin.

Another key finding in the report was that the majority of individuals—70 percent—who were disenrolled were for procedural reasons rather than being found ineligible based on the information provided. Data also indicates that 60 percent of renewals were completed through an ex parte process, where enrollees did not need to provide any new information. Because redetermination data was not tracked prior to unwinding, it is not clear how these percentages compared to outcomes prior to the COVID-19 public health emergency.