each year to renew their coverage.

But that# stopped during the onset of the An d, for three years, recipients# have been continuously enrolled.## But that reenrollment provision# ended in April.

And, since then,## more than 15 million people have# been disenrolled from Medicaid.

We're joined now by Jennifer Tolbert,## deputy director of the Program on# Thank you for being with us.

So, Jennifer people forgetting to reenroll# or is something else at play?

JENNIFER TOLBERT, Deputy Director, Program on# Medicaid and the Uninsured, KFF: Well, I think## it So, because states kept people on the Medicaid# program for three there are a number of people who# have had changes in circumstances,## they have gotten new jobs, they have# increased their hours at their existing jobs,## and because of that increase in# income, are no longer eligible.

But we also know that there are a lot of people# who are losing coverage for what are called## procedural or paperwork reasons.

And this is# a situation in which the state is disenrolling## someone, even though they don't have information# to confirm whether the person is still eligible.

GEOFF BENNETT: And who is# most affected by that?

And## what about children who are covered# by M JENNIFER TOLBERT: Yes, we're seeing a# lot of disenrollments among children.

I think going into this process, the assumption# was because Medicaid el higher than that for adults, that there would be# fewer disenrollments among children.

But among## reporting states, and we only have data from# about 23 states, but among those states showing## disenrollments broken out by age, children account# for nearly 40 percent of all disenrollments.

And so, nationally, that translates to# about five million children losing coverage.

GEOFF BENNETT: And when people lose coverage, what# exactly are they losing?

What's at stake here?

JENNIFER TOLBERT: Yes, well, they're# losing their access to medical care.## And many people on Medicaid are dealing# with chronic health conditions or mental## health issues for which they need# ongoing medication and treatment.

And particularly for kids, this can mean# losing access to needed medications to## control ADHD or to help with autism or# diabetes.

And so losing Medicaid coverage,## even if it may be for a short period while# someone is trying to get reenrolled, can lead## to lapses in care, so people not being able to# get needed medications, not being able to see## doctors or therapists that can help them control# whatever health care issue they're dealing with.

GEOFF BENNETT: You know, looking at the numbers,# there is a wide range of disenrollment rates## across the country, 61 percent in Texas to# 13 percent in Maine and Oregon.

Why is that?

JENNIFER TOLBERT: Yes, there are a# lot of different factors at play here.

Some of it has to do with when states# started disenrolling people.

Some states## started earlier than others.

Other states# have taken greater steps to try and ensure## that people who are still eligible remain# on the program.

So one thing that states## are doing or required to do, in fact, is to# conduct what are called ex parte reviews.

And this is where state checks# available data sources to see## if an individual continues to qualify# for Medicaid before they send a renewal## notice asking someone to complete forms# and provide other documentation.

States## that have higher ex parte renewal rates# tend to have lower disenrollment rates,## because they are able to enroll or renew more# people without asking people to take action,## which can be burdensome, or which can lead# to problems like people not receiving notices## in the mail or not being able to gather the# required documents that the state is requesting.

GEOFF BENNETT: If someone believes that they have# been improperly disenrolled, what can they do?

JENNIFER TOLBERT: Yes.

unfortunately, this can be difficult in# many states because there are still long## wait times for many call centers# when people try and get through.

But my advice is to stay patient and# continue to try and get through to## the Medicaid agency.

If not that, there are# community-based organizations and entities## called navigators and enrollment assisters# that can provide people with help to complete## their renewal process or to challenge if they# think they have been improperly disenrolled.

GEOFF BENNETT: Jennifer Tolbert with KFF, thanks# so much for your insights.

We appreciate it.

JENNIFER TOLBERT: Thank you.