Roundup: 7M Americans lose Medicaid coverage, bail reform and a ban on plastics

It’s Saturday, Sept. 23, and we’d like to welcome you to the weekly State and Local Roundup. There’s plenty to keep tabs on, with Mainers set to vote on whether to keep their two biggest utilities, Miami City Hall awash in scandal, Pennsylvania adopting automatic voter registration and bail reforms going into effect in Illinois.?

But first, we take a look at significant developments in state efforts to end pandemic-era Medicaid policies that allowed millions of Americans to get public health insurance for three years without routine checks into their eligibility. This week, KFF, formerly the Kaiser Family Foundation, reported that nearly 7.2 million people have lost coverage as a result.

Medicaid is the biggest health insurance program—public or private—in the country. As of the end of last year, it covered more than 92 million low-income Americans and people in other vulnerable groups. It is jointly run by and paid for by the federal government and individual states.

States began the process of reverifying the eligibility of Medicaid recipients in April, and under federal law, they have one year to complete the process. But states have taken different approaches to the task. Some moved quickly to pare the rolls, often by prioritizing checks of enrollees that they suspect no longer qualify for the program. Other states are simply verifying recipients as their regularly scheduled renewal dates come up.

As a result, there have been large differences among states in how many Medicaid recipients have been disenrolled, according to KFF. Texas leads the pack, with 888,000 people losing coverage. Next is Florida, with 700,000 recipients removed from the program. And Arkansas ranks third, with nearly 374,000 people off the rolls.

States also differ greatly in the rate of people they contacted that have been removed. In Texas, 69% of recipients the state reached out to were taken off the program, the highest rate of any state. In Maine and Oregon, though, that rate was just 14%, the lowest in the country.

Nearly three-quarters of people across the country that have lost coverage were removed for procedural reasons, such as not filling out required paperwork on time. The rest were found ineligible for substantive reasons, like exceeding the income thresholds for the program.

The level of detail available to researchers and the public about how Medicaid disenrollments are handled is new. Congress included new reporting requirements for states in a budget bill it passed last year. States have to provide details about the disenrollment process in order to receive a higher reimbursement rate from the federal government.

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News to Use

Trends, Common Challenges, Cool Ideas, FYIs and Notable Events

• PUBLIC UTILITIES: Will Mainers vote their two biggest utilities out? On Nov. 7, residents will decide whether to initiate a public takeover of the state’s two investor-owned utilities, which together service more than 96% of Maine’s electric demand. The ballot initiative, called Question 3, would create a new nonprofit company to purchase the electric transmission and distribution systems currently operated by the for-profit utilities, which have been plagued by poor reliability rankings, blasted for high prices and are bottom of the barrel for customer satisfaction. Utility experts and public power advocates are watching, as there is broad agreement that nothing like it has been seen at the state level since Nebraska began absorbing investor-owned utilities into public power districts in the 1930s and 1940s.
• BAIL REFORM: New bail reforms go into effect in Illinois. The state’s historic bail reforms that eliminates cash bail as a condition of release from jail went into effect this week, after a nine-month delay due to litigation from prosecutors across the state who opposed the law. Though a number of jurisdictions have eliminated or reduced cash bail in some form, Illinois is the first state to fully eliminate it legislatively. Proponents of the law have long argued that cash bail deepens disparities in the system by disproportionately jailing people too poor to make bail, though some progressive advocates are citing concern about the law leading to an overreliance on electronic monitoring.
• ENVIRONMENT: Massachusetts will stop buying plastic, governor says. Gov. Maura Healey made the announcement on Monday, saying “I will sign an executive order that bans the purchase of single-use plastics by state agencies in Massachusetts.” According to Healey, her order will make Massachusetts the first of 50 state governments to stop purchasing single-use plastic bottles officially. The order will be effective immediately upon issue.

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Government in Numbers

38 million

The pounds of garbage and other debris strewn across roads, rest areas and public lands last year in Washington state, according to a new Department of Ecology-commissioned study. That’s nearly 5 pounds per resident annually. More than 8,000 pieces of trash, including cigarette butts, food wrappers, snack bags and glass bottles, peppered each mile of the state’s roadways last spring. That’s well above a national average of about 5,700 pieces per mile presented in a different report, the Washington State Standardreported. “It’s heartbreaking to see the most beautiful state in the country marred by litter,” Gov. Jay Inslee said in a statement.

ICYMI

Funding for WIC food assistance remains uncertain amid budget fight

As food costs increase, more women than expected have been signing up for the program. Without increased funding, states may have to turn women and their children away.

BY KERY MURAKAMI

GOP states announce new voter roll systems. Are they as secure as ERIC?

An expert in elections administration and one of the founders of ERIC says the new systems could suffer from low data quality, high costs and inadequate security.

BY DANIEL C. VOCK

Are tax incentives boons or boondoggles?

Though there’s lots of evidence that the economic development tool may not be effective, it is still in wide use. Fortunately, there are ways to control the potential waste of taxpayer dollars.

BY KATHERINE BARRETT & RICHARD GREENE

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