By: Nathaniel J. Greene, Community & Culture Reporter

As the nation inches closer to another crucial election, a quiet but devastating crisis is unfolding across the United States. The “great unwinding” of Medicaid, a program designed to be a lifeline for low-income individuals and families, is causing millions to lose their health coverage—not because they no longer qualify, but due to bureaucratic hurdles and state decisions that disproportionately affect communities of color.

This issue was brought to light during a recent briefing titled “Strengthening Medicaid and Closing the Coverage Gap,” held by Ethnic Media Services on Aug.9. The briefing highlighted how the unwinding process is unraveling years of progress made in expanding healthcare coverage under Medicaid, particularly in states that have chosen not to expand their Medicaid programs under the Affordable Care Act (ACA).

A Broken System Unwinding

Katherine Hempstead, Senior Policy Adviser at the Robert Wood Johnson Foundation, set the stage by emphasizing the magnitude of the Medicaid program, which currently provides free or low-cost health insurance to over 83 million Americans. However, the end of pandemic-era continuous coverage protections has placed approximately 23 million people at risk of losing their coverage.

Hempstead noted, “The staggering reality is that 69 percent of these individuals have been disenrolled not because they were ineligible, but due to paperwork and procedural technicalities.”

Expanding Medicaid to close the coverage gap is crucial for increasing coverage rates and achieving health equity, particularly in the aftermath of the unwinding. Hempstead highlighted the ongoing struggle, stating, “We’re talking about one big program, but at the same time, we’re talking about 50 different programs, because each state has its own Medicaid agency, leading to a fragmented system that’s failing those who need it most.”

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The Dire Impact on Communities of Color

Martha Sanchez, Health Policy and Advocacy Director at Young Invincibles, provided a sobering perspective on how this crisis is disproportionately affecting young adults and communities of color.

“Young adults remain the highest uninsured population of any age group, making up 47 percent of that Medicaid coverage gap,” Sanchez explained. She added, “We’re in a crisis where our healthcare systems are not meeting the needs of our health.”

Sanchez’s remarks underscored the vulnerability of this demographic, particularly in states that have resisted Medicaid expansion. “These states have some of the worst health inequities in the country,” she said. “The fact that young people are suffering from more severe health conditions and yet are losing access to coverage is a recipe for disaster.”

Children: The Collateral Damage

Joan Alker, Executive Director and Co-Founder of the Center for Children and Families at Georgetown University, shifted the focus to the impact on children, especially those in communities of color. Alker pointed out that “5 million fewer children are enrolled in Medicaid today compared to before the unwinding began.”

She stressed that many of these children are still eligible but have been wrongfully disenrolled due to administrative issues. “We knew when this unwinding started that many of these children would lose coverage, and it’s heartbreaking to see it happening.”

Alker urged community leaders and advocates to take action, especially as children head back to school. “This is a really important moment,” she said. “We need to get the message out that many of these children remain eligible for Medicaid, and we must do everything we can to get them re-enrolled.”

A Call for Urgent Action

Stan Dorn, Director of the Health Policy Project at UnidosUS, closed the discussion by calling for systemic changes to prevent such a crisis from happening again. “The great unwinding has shown us the cracks in our system,” Dorn stated. “We need to eliminate administrative burdens for as many people as possible, and we must hold states accountable for protecting their residents’ health.”

Dorn’s words were a stark reminder of the stakes involved. “If every state in America did as well as the top 10 states in protecting children’s coverage, over 4 million additional children today would have Medicaid. That’s the price we’re paying for the system we have.”

As the unwinding continues, the need for immediate and comprehensive action is more urgent than ever. The briefing was a clarion call to policymakers, advocates, and communities to rally together to ensure that Medicaid fulfills its promise of providing equitable health coverage to all, particularly the most vulnerable among us.