![]() Molina gained 750,000 Medicaid members during the pandemic pause, and expects about half of them to be dropped from the rolls, according to an earnings report issued last month. The company will lose $2 billion once redeterminations are complete, Wright said. Nearly 78% of the company’s $31.97 billion in revenue last year came from Medicaid. These figures help explain why the health insurance industry group AHIP, the Federation of American Hospitals and other healthcare organizations have partnered to provide assistance and resources to people who will have to switch from Medicaid to another form of health coverage.Īmong insurers, Molina Healthcare faces the greatest financial risk because it is the least diversified, said Duane Wright, a senior research analyst at Bloomberg Intelligence. About a third of those will turn to the health insurance exchange marketplaces for alternative coverage, and 65% of adults will qualify for job-based health insurance, according to the Urban Institute. With President Joe Biden's announcement that he would allow the federal public health emergency to lapse on May 11, states are free to resume redeterminations as soon as April 1.įor Medicaid insurers, the looming loss of coverage threatens a financial shock.Īn estimated 15 million of the 91 million people with Medicaid-or 16.5%-are expected to lose benefits once states begin scrutinizing enrollment, according to the Health and Human Services Department. The federal government offered states extra financial support for Medicaid on the condition that they not remove people from the rolls even if their incomes rose above eligibility standards. Medicaid redeterminations have been on pause for more than two-and-a-half years to enable people to remain covered during the COVID-19 pandemic. ![]() Other top health plans with Medicaid managed care members include Aetna Better Health of Illinois, with a 15.4% share as of last March, Count圜are Health Plan with 14.9%, Molina Healthcare with 12% and Humana with 0.6%. Meridian Health Plan and YouthCare have a combined 929,069 members, or 32.4% of the Medicaid managed care members in the state.īlue Cross & Blue Shield of Illinois, with 706,257 Medicaid managed care members, has 24.6% of those members here. In Illinois, Centene stands to lose the most from redeterminations among members of its two Medicaid managed care plans.
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