Idaho acted quickly to remove people from Medicaid after special COVID-19 protections expired in April, including health coverage for tens of thousands of children.

In a process called Medicaid unwinding, the Idaho Department of Health and Welfare determined more than 120,000 people were no longer eligible for the program.

Hillarie Hagen, health policy associate at Idaho Voices for Children, said many people were disenrolled from Medicaid for procedural reasons and the renewal process was unclear.

"The confusion around the renewal process often results in families not really finding out that their child has lost Medicaid until they show up at the doctor or when they go to the pharmacy to pick up a potentially lifesaving prescription or an asthma inhaler," Hagen explained.

During the first four months of Medicaid unwinding in Idaho, more than 20,000 children lost health coverage, according to Georgetown University data.

Hagen argued consistent health coverage is essential for healthy development, especially for young children.

"Even a very short lapse in health coverage for children can result in delayed care, unaddressed medical conditions like asthma," Hagen pointed out. "All it takes is one broken arm to put a family with low income in a financial crisis."

Hagen stressed policymakers should evaluate why so many children were disenrolled from Medicaid during this process.

"To see where the opportunities are to make improvements, to help make things easy to navigate for families so that children don't lose coverage unnecessarily if they're still eligible, or have gaps in coverage," Hagen urged.

Open enrollment through Your Health Idaho for health coverage in 2024 is open through Dec. 15.


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More than 300,000 children have been dropped from Medicaid and Peach Care for kids since the pandemic ended.

A report from the Georgetown University Center for Children and Families pinpoints a nationwide trend: More than 4 million kids were left uninsured, soon after the COVID public-health emergency ended.

Georgia ranks third-highest for the number of children who have lost coverage.

Judy Fitzgerald, executive director of Voices for Georgia's Children, said many lost coverage because of procedural reasons rather than eligibility.

"They're not ineligible, but there was missing or incomplete paperwork, or what we know from families is, they felt like they didn't receive the notification, they didn't know," she said. "And so, there are a large number of children who are still eligible."

Fitzgerald said the repercussions of disenrollment can be dire, as when children can't get timely access to health-care services, they're more vulnerable to illnesses and developmental delays. The report also found parents with access to employer-sponsored health plans can't always afford the cost of adding their dependents.

While parents face higher income requirements for Medicaid, many children who lost coverage during the pandemic are still eligible. Fitzgerald said Voices for Georgia's Children is advocating for ways to increase enrollment for children, including a more simplified enrollment process and assistance from state agencies to expedite screening.

"So, we're asking the state to expand the kinds of organizations that could screen kids for eligibility, and enroll them in coverage temporarily while the state processes an official enrollment," she added, "and this is something called presumptive eligibility."

She said programs such as SNAP, and information through the Department of Labor, could be used to facilitate renewals. For families who don't qualify, she said, alternative coverage options are available through the insurance marketplace. Navigators through Georgians for a Healthy Future can help find them.

The Medicaid and Nevada Check Up programs had more than 13,000 fewer children enrolled last year than during the pandemic, according to new research from the Georgetown University Center for Children and Families.

States have been reexamining Medicaid benefits since the pandemic ended, and disenrolling families based on their head-of-household's eligibility. Carissa Pearce, health policy manager for the Children's Advocacy Alliance, said this means some children were also dropped from coverage who are still eligible.

As a result, she said, the Centers for Medicare and Medicaid Services told states to stop disenrolling and ensure they were looking at individual eligibility.

"Meaning that children would be screened separately from their parents, and that was a really important change," Pearce explained. "Specifically in Nevada, every person who had been disenrolled up to that point in August and September of 2023 were reinstated for their coverage, so that they could fix their system and then proceed with disenrollments."

Pearce said Nevada didn't start disenrolling children again until January of this year, giving families more time to check the requirements and submit the documentation to keep their coverage. But from January to February, about 1,500 Nevada children were dropped. She said it's important for families to see if their child is eligible for Nevada Check Up or consider a state marketplace insurance program at nevadahealthlink.com.

Tara Raines, deputy director of the Children's Advocacy Alliance, said her message to families is to not avoid medical appointments if they suspect their child may not be covered. She said there are other programs that families can be directed to, and thinks the state could do more to reach and inform families.

"I think a campaign that lets people know, 'Hey, you were disenrolled from Medicaid, here are your options,' would be incredibly helpful," she said, "and I don't know if that looks like partnering with school districts."

Raines said families' living conditions and circumstances vary in the Silver State. This could mean some may not have a permanent address, but should not mean they go without health coverage.


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More than one million children in Texas no longer have health insurance through Medicaid, despite being eligible for coverage, according to a new report from the Georgetown University Center for Children and Families.

During the COVID-19 pandemic, states were not allowed to cancel coverage - then last year, state health departments were tasked with rechecking the eligibility of Medicaid recipients.

Brittney Taylor-Ross, senior policy analyst with the advocacy group Every Texan, said despite the option to slowly complete the task, Texas chose to do it in one year's time.

"We didn't take up a lot of the flexibilities that were offered, so that was a state choice at the leadership level. We also chose to go through this unwinding process pretty quickly. Other states have paused their process when they've seen that things don't look right," Taylor-Ross said.

The report shows Texas has disenrolled more children than any other state. Anyone who lost coverage must reapply. Taylor-Ross said as of April, the median amount of time to process a new Medicaid application is 95 days. Federal law requires this number to be 45 days or less.

Most families don't realize they no longer have coverage until they go to the doctor's office.

Joan Alker, research professor, McCourt School of Public Policy, and executive director, Georgetown University Center for Children and Families, said the problem affects not only families, but the pediatricians and clinics that treat them.

"Kids are going to miss out on those well-child visits, they're going to miss out on getting the medications they need - be it an inhaler for their asthma or an ADHD medication. And that really sets them back, both in their health and their success in school," she said.

Because of the unwinding, more than 4 million fewer children are enrolled in Medicaid. One out of four of those children lives in Texas.