Access to Care Among Individuals Who Experienced Medicaid Lockouts After Premium Nonpayment

As of September 2019, 5 states have received federal waivers to temporarily suspend Medicaid eligibility for individuals who fail to pay required premiums. These periods, ranging from 3 to 12 months, are called lockouts, noneligibility periods, or restrictive reenrollment periods. Wisconsin received a Section 1115 waiver allowing the application of premiums enforced by lockouts among adults receiving transitional medical assistance (TMA), a federally required Medicaid category that provides time-limited coverage to parents and/or caretakers when their incomes increase to exceed the Medicaid program maximum. Wisconsin did not expand Medicaid under the Patient Protection and Affordable Care Act; TMA covers some individuals who would otherwise be eligible for the expansion.

A team of authors including HIP Investigator, Dr. Marguerite Burns conducted a survey study comparing the demographic characteristics, access to care, and health status of recent Medicaid enrollees in Wisconsin with and without experience of Medicaid lockouts.

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