Other states have also removed a large number of Medicaid recipients for procedural reasons. In Indiana, nearly 90 percent of the roughly 53,000 people who lost Medicaid in the first month of the state’s unwinding were booted on those grounds. In Florida, where nearly 250,000 people lost Medicaid coverage, procedural reasons were to blame for a vast majority.
In addition to taking different approaches to removing people from Medicaid, states are also releasing data about their progress in different ways, making it difficult to compare their strategies in the early stages of the unwinding. “We’re comparing apples to oranges to tangerines,” Ms. Alker said.
Some people who lose Medicaid coverage are expected to get health insurance through their employer. Others are likely to turn to the Affordable Care Act’s marketplaces to sign up for private insurance, and many of them will be eligible for plans with no premiums.
Debra Miller, 54, of Bullhead City, Ariz., lost Medicaid coverage in April after her roughly $25,000 annual salary as a Burger King cook left her ineligible. Ms. Miller, a single mother with diabetes and hypothyroidism, worked with an insurance counselor at North Country HealthCare, a network of federally funded health clinics, to enroll in a marketplace plan with a roughly $70 monthly premium.
“It’s a struggle because it’s a new bill that I haven’t had before,” she said. Her new plan, she added, does not include vision insurance, leaving her worried about paying for eye appointments she needs as a diabetic.
Ms. Buford said that for some people in Arkansas, marketplace coverage would be too expensive.
“You have a car, mortgage, kids, food,” she said. “You really don’t have that much left to pay that much for health insurance.”
Ms. Buford said that her job helping others find health insurance in underserved areas was a calling inspired by watching her grandmother struggle to afford her medications and rely on food pantries. Ms. Buford went to a community college near her hometown so she could take care of her sick father, who passed away in his 40s. “I love my job because I’m able to help people,” she said.