'Imminent Danger': Millions Set to Lose Medicaid, Food Benefits Once Public Health Emergency Ends

In less than three months, millions of people across the U.S. could be kicked off Medicaid and see their food benefits slashed if the Biden administration declines to further extend the federal public health emergency that was first declared at the start of the coronavirus pandemic.

Last week, Health and Human Services Secretary Xavier Becerra announced an extension of the public health emergency (PHE) until January 11, but it's not clear whether the administration is planning another renewal--leaving millions of households concerned about their health coverage and Supplemental Nutrition Assistance Program (SNAP) benefits.

"Urgent action will be necessary to stabilize health and food security among those at greatest risk."

More than 40 million people across the U.S. are currently receiving SNAP benefits and around 90 million are on Medicaid or the Children's Health Insurance Program (CHIP).

In an op-ed published by STAT on Tuesday, Allison Maria Lacko, Allison Bovell-Ammon, and Richard Sheward noted that "many individuals and families will experience the cumulative impact of losing access to both Medicaid and SNAP or losing access to Medicaid and having SNAP benefits reduced."

Coronavirus response legislation signed into law in March 2020 boosted state Medicaid and SNAP funding and loosened eligibility requirements, allowing millions more people to enroll as the pandemic wreaked havoc. Crucially, the bill also included a "continuous coverage" requirement that bars states from removing people from Medicaid while they're still receiving the extra federal funding.

That provision has allowed millions of people, including kids on CHIP, to maintain health coverage throughout the deadly pandemic, which threw millions out of work and off their employer-provided insurance.

Once the PHE is allowed to lapse, states will resume eligibility screenings and begin removing people from the program if they're deemed ineligible. The Biden administration estimated in a recent study that 15 million people--including more than 5 million children--could lose coverage once the PHE declaration ends.

The administration stressed that many could have their coverage stripped despite still being eligible for Medicaid, a problem attributed to "administrative churning" that "can occur if enrollees have difficulty navigating the renewal process, states are unable to contact enrollees due to a change of address, or other administrative hurdles."

Emergency SNAP expansions will also unwind, a potential disaster as hunger remains high across the U.S. even as pandemic-related measures have largely kept it from skyrocketing.

The Food Research and Action Center estimates that most SNAP recipients will see their benefits cut by $82 a month when the PHE ends.

In their STAT op-ed, Lacko, Bovell-Ammon, and Sheward argued that "urgent action by healthcare systems, community organizations, and all levels of government will be necessary to stabilize health and food security among those at greatest risk."

"While vaccines and treatments lessen the life-altering threat of Covid-19," they added, "it is important not to lose sight of the imminent danger to health posed by the expiration of effective expansions of Medicaid and SNAP."

HHS has said it will give states a 60-day notice before lifting the PHE, which has been extended 11 times since the start of a pandemic that is still killing hundreds of people every day in the U.S.

Last month, President Joe Biden claimed during an interview that "the pandemic is over," a remark that congressional Republicans cited to demand a formal end to the PHE and billions in Medicaid funding.

While advocates have been warning for months that the end of the PHE could come with devastating consequences for vulnerable Medicaid and SNAP recipients--and public health more broadly--little has been done at the state or federal level to avert disaster.

Advocates have urged Congress to use must-pass spending legislation to shore up Medicaid and SNAP benefits before millions lose access.

"Congress can help maintain recent health coverage gains through enacting policies including postpartum coverage, continuous eligibility, and funding for Puerto Rico and the territories," Allison Orris, a senior fellow at the Center on Budget and Policy Priorities, wrote earlier this month.

"As policymakers negotiate the year-end spending bill," Orris added, "they should also consider other policies--such as a permanent reauthorization of CHIP and inclusion of the proposed Medicaid Reentry Act--that also could help people with low incomes gain, retain, or access the coverage they need."