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Miami Herald
3 days ago
- Health
- Miami Herald
Nearly 700,000 Americans Lose Health Care Coverage in 2025
Almost 700,000 Americans lost Medicaid coverage in one month at the start of this year, according to new enrollment data compiled by KFF. The significant drop in Medicaid enrollment in January from December 2024 is part of a long-term trend amid the continuation of the federal program's "unwinding" process, which began after pandemic-era protections ended. Enrollment was still higher in January than it was in February 2020. The data highlights the continued ripple effects of the Medicaid policy shift, with millions more likely to be affected in the months ahead-particularly low-income families, children, and older adults who rely on Medicaid for basic care access. Health care experts and advocates warn that the unwinding process is opening large gaps in the U.S. health care system, with many falling through the cracks due to administrative barriers or lack of communication, not because they no longer qualify. Data collected by KFF shows that from December 2024 to January 2025, Medicaid enrollment dropped by 669,938, bringing the total number of Americans enrolled in Medicaid to around 71.2 million. While this number remains high, it reflects a steady monthly decline that began in 2023 when states resumed redeterminations, where they checked whether enrollees were still eligible for benefits. The process had been paused during the COVID-19 public health emergency alongside an expansion to the federal protection available for vulnerable Americans with limited income and resources. When those protections were lifted following the pandemic, millions faced the risk of being disenrolled-not just due to income changes, but because of paperwork errors, missed deadlines, or outdated contact information. According to KFF's data, more than 16 million people have been disenrolled from Medicaid since the unwinding began in the spring of 2023. An April 2024 survey by KFF of 1,227 U.S. adults who had Medicaid coverage in prior to April 1, 2023, found that 28 percent of former enrolees found other forms of health coverage, while 47 percent were eventually re-enrolled to Medicaid. Around a quarter of enrolees reported as remaining uninsured. States like Montana, Tennessee and Colorado have seen some of the largest decreases in enrollment, with levels in January 2025 dropping below pre-pandemic levels. William Schpero, assistant professor of population health sciences at Weill Cornell Medicine, told Newsweek: "This is evidence that we are likely still seeing the effects of the end of the continuous coverage provisions in place during the COVID-19 Public Health Emergency that paused redeterminations of Medicaid eligibility. During the 'unwinding' of continuous coverage through September 2024, close to 70 percent of those who lost coverage were disenrolled for purely procedural reasons-for example, they missed a required renewal form because of a change in address. Many of these people likely remained eligible for Medicaid." He added: "It would be particularly concerning if procedural terminations continue to underlie the latest reported decreases in Medicaid enrollment. It suggests that states can be doing more to prevent avoidable losses of coverage. Research has estimated that a large portion of individuals who have lost Medicaid in recent months have become uninsured or experienced gaps in coverage. We have consistent evidence that loss of Medicaid coverage interrupts access to care - without coverage, people forgo visiting the doctor or taking their prescribed medications due to cost. Ultimately this will hurt health outcomes." Kathleen Adams, professor of health policy and management at Emory University's Rollins School of Public Health, Georgia, told Newsweek: "We are always concerned with the loss of insurance coverage, especially among the lower income and vulnerable groups traditionally served by Medicaid. If these individuals are not able to find a source of other coverage such as Employer Sponsored Insurance (ESI) or through the subsidized exchanges, they will have lower access to needed health care, face higher costs if they obtain care and could impose costs on the health care system as they are forced to seek care in ERs or other publicly subsidized sources of care." She added: "The unwinding has taken place over a year and as the report notes, Medicaid enrollment is still higher now than in the pre-pandemic period. It is also important to note the differences seen across states. Some states that had not expanded Medicaid under the ACA did so recently and many of them show the largest increases in enrollment from their pre-pandemic levels. Currently, the concerns with Medicaid enrollment are with the administration's proposed changes to Medicaid eligibility which some states are already seeking to implement." Unless policies change, experts project that millions more Americans may lose health coverage through 2025, not just due to changes in eligibility requirements, but also because of bureaucratic hurdles. Related Articles VA Marks Benefits Milestone For VeteransCan Tackling Addictions Reduce Medicaid Costs?Most Republicans Enrolled in Medicaid 'Worried' About Funding Cuts-PollAmerican's Trip to Italy Leads to Shocking Revelation About US: 'So Much Resentment' 2025 NEWSWEEK DIGITAL LLC.
Business Insider
23-04-2025
- Health
- Business Insider
Leading through change: How purpose-driven project management can bridge equity gaps in public health
By Caroline Obeahon, April 23, 2025 In the complex world of public health, transition is inevitable, whether through shifting policies, evolving community needs, or the expiration of emergency declarations. As a project manager deeply embedded in this space, I've learned that leadership during these transitions requires more than technical skill. It demands clarity of purpose, cultural responsiveness, and an unwavering commitment to equity. My transition into the public health sector from the oil and gas energy industry wasn't just a career shift; it was a personal mission ignited by life-changing experiences within my own family. Navigating the healthcare system during a crisis revealed the daily disparities that too many underserved communities face. That realization became a catalyst: I knew I had to be part of the solution. Today, I lead public health initiatives focused on Medicaid populations, community outreach, and Social Determinants of Health (SDoH). I've witnessed firsthand how project management, when grounded in purpose and inclusion, can drive transformational outcomes. Leading Through Uncertainty: The COVID-19 Public Health Emergency (PHE) One of the most defining chapters of my public health journey began with the unwinding of the COVID-19 PHE. The expiration of federal protections meant that millions risked losing Medicaid coverage. My role was to lead response efforts that supported continuity of care, especially for vulnerable populations. We partnered with state and federal agencies, compliance officers, and community health organizations to coordinate outreach and realignment efforts. We implemented multilingual, multichannel engagement strategies, ensuring every member had clear, timely information about their eligibility and options. But the work was not just about compliance. It was about compassion. Effective leadership in transitions like these hinges on empathy. I spent time listening to frontline staff and impacted members. Their voices shaped the policies we developed and the systems we implemented. Our strategies weren't built in silos; they were community-informed and equity-centered. The SDoH Imperative: Moving Beyond the Clinic If the PHE response taught us anything, it's that health doesn't begin in the hospital; it begins in the home, at the dinner table, in the classroom, and at work. That's why I've led initiatives that address the root causes of health disparities through SDoH programming. Our efforts included launching lunch-and-learn sessions for members and staff, building community partner networks, and designing value-added services (VAS) focused on housing, nutrition, education, economic support, and social inclusion. Each VAS initiative was tailored to address one or more of the five key pillars of SDoH — making it easier for families to access resources that have a direct impact on their health and well-being. For example, we launched transportation assistance services to ensure members could attend prenatal appointments, partnered with food banks to deliver nutritious meals to families experiencing food insecurity and community-based organizations that provide health and wellness services to the underserved. We also offered digital literacy workshops, recognizing that access to online health portals and telemedicine is a growing determinant of care. Each initiative was data-informed and outcomes-driven. In project management, we often ask: What does success look like? In public health, that question must be reframed: Who defines success? For me, it's the community. If a family gains housing stability because of a resource we connected them with, that's impact. If a child doesn't miss school because their family received the preventive care they needed, that's equity in action. The Role of Project Managers in Advancing Health Equity Public health needs project managers who do more than manage, it needs leaders who advocate. We must lead with integrity, clarity, and a vision for systems that serve everyone. That means designing projects that reflect real life, not just regulations. It means bringing together cross-functional teams who reflect the communities they serve. And it means using every project milestone as an opportunity to challenge inequity. In my work, I constantly remind teams: metrics represent people. That human-centered approach has helped me build trust across departments and with the public. It's how we turn technical implementation into transformational change. Lessons in Leadership During Transitions Center the Mission – When change comes fast, purpose becomes your compass. Stay anchored in the "why." Design With, Not For – Engage community voices early and often. Co-creation builds programs that work. Communicate Relentlessly – In uncertain times, clear and consistent messaging builds trust. Challenge the Status Quo – Systems weren't built for everyone. Use your position to advocate for equity-focused change. Measure What Matters – Go beyond compliance. Track outcomes that reflect lived experience. A Call to Action As public health systems continue to evolve and adapt to future challenges, we have an opportunity and an obligation to lead differently. Let's build systems that heal, policies that include, and programs that empower. Whether you're a policymaker, a frontline health worker, or a fellow project manager, your leadership matters. Lead with humility. Lead with strategy. But above all, lead with purpose. Because when we bring heart to the headwork, we don't just manage change, we create it. — Caroline Obeahon is a public health project manager with over 16 years of cross-sector experience. She specializes in community health engagement, Medicaid transitions, and Social Determinants of Health (SDoH) programs. --
