Stricter Medicaid policies lower access to prescription medications
After the COVID-19 public health emergency, when Medicaid continuous enrollment ended, Americans lost access to medications, with fewer prescriptions filled to treat conditions ranging from colds and allergies to cancer, diabetes, HIV, and depression, according to a new study co-authored by researchers at Harvard T.H. Chan School of Public Health.
The study was published Jan. 2 in JAMA Health Forum and was led by Benjamin Rome, instructor in the Department of Epidemiology at Harvard Chan School, assistant professor at Harvard Medical School, and associate physician in the Division of General Internal Medicine and Primary Care at Brigham and Women’s Hospital. Other Harvard Chan co-authors included Benjamin Sommers, Huntley Quelch Professor of Health Care Economics, and Adrianna McIntyre, assistant professor of health policy and politics.
In 2020, in response to COVID-19, lawmakers passed a provision incentivizing states to halt their Medicaid enrollment redeterminations, allowing Americans to remain in the program and maintain their health insurance coverage regardless of continued eligibility. Medicaid enrollment grew rapidly—then began to shrink in 2023, when the provision expired and states re-enforced their eligibility requirements, a period known as “Medicaid unwinding.” According to the researchers, the health consequences of both Medicaid continuous enrollment and unwinding are important to understand as they may preview the potential impacts of recent federal cuts to Medicaid.
To learn more, the researchers used data from the Centers for Medicare & Medicaid Services to examine fluctuations in Medicaid enrollment and reimbursements for prescription medications. They found that Medicaid enrollment increased by 2.4% per quarter of the continuous enrollment period and decreased by 4.9% per quarter of the unwinding period. Concurrently, the number of prescriptions increased by 1.9% per quarter and decreased by 3.9% per quarter.
The researchers observed that these fluctuations varied state by state. Some implemented protective policies to ensure that those eligible for Medicaid were not accidentally disenrolled during the unwinding period—and these states saw negligible decreases in prescriptions. The researchers wrote that these kinds of policies, as well as other strategies such as investing in outreach and assistance navigating Medicaid enrollment processes, “will be particularly important in light of new laws that mandate Medicaid work requirements and increase the frequency of redeterminations for Medicaid eligibility.”
Read the study:
Changes in Medication Use During Medicaid Continuous Enrollment and Unwinding
Learn more:
How Medicaid cuts could lead to loss of coverage for millions (Harvard Chan School news)
Medicaid cuts: What’s at stake (Harvard Chan School news)
