Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.


The end of the COVID-19 public health emergency this spring brought with it a massive health care challenge: redetermining eligibility for the 94 million people across the nation who depend on medical assistance.

These programs have understandable income restrictions and other requirements. Eligibility checks were suspended during the pandemic but restarted earlier this year. There's an undeniable public interest in ensuring that those who remain eligible for coverage not lose access to care because of a paperwork snafu.

Healthy families and workers are vital to the nation's and this state's future. About 1.5 million Minnesotans — 1 in 4 — are covered by public health care programs.

While it's too soon to tell how Minnesota stacks up to other states in preventing eligible enrollees from falling through coverage cracks, the strategy here has commendably been one of care, not haste, under the leadership of the state's Department of Human Services (DHS) Commissioner Jodi Harpstead. Early data gathered by KFF, a respected health care policy nonprofit, suggests this conscientious approach is serving Minnesota well.

Unfortunately, some states rushed into re-determination, beginning "disenrollments" in April, with others following in May — essentially booting people off medical assistance as soon as possible. As of Tuesday, across the nation, at least 3.7 million Medicaid enrollees have had coverage terminated, including at least 307,000 children, according to KFF's tracker.

Texas has the dubious distinction of having disenrolled the most so far. About 501,000 there have lost coverage, KFF calculated. Florida is next with 408,000.

KFF also tracks how many enrollees have been "terminated" for procedural reasons, which happens when "people are disenrolled because they did not complete the renewal process and can occur when the state has outdated contact information or because the enrollee does not understand or otherwise does not complete renewal packets within a specific timeframe."

Alarmingly, 73% of disenrollments overall are due to this vs. an ineligibility determination, according to KFF. New Mexico ranks first among states on this dismaying metric. Just 4% of those terminated were determined ineligible; 96% were dropped for procedural reasons.

Other states with high procedural terminations include Georgia and South Carolina, where 93% of disenrollments were for this reason. California ranks fifth with 89%. Texas comes in ninth, with 81%.

The data suggests that many people who may still be eligible for Medicaid coverage are instead losing it as the redetermination process continues for months to come. That's unacceptable.

While completing paperwork may not sound daunting, those served by medical assistance are struggling to get by. They may move often, making it difficult for paperwork to reach them. They may also not have easy access to email or other technology. It's easy to see how red tape entanglement could cut off coverage.

Minnesota doesn't appear on KFF's state comparison because of its deliberative approach, which includes extending the deadline for the first enrollee group facing disenrollment.

Some background: The state divided medical assistance enrollees into 12 groups for eligibility redetermination. About 92,000 people were in the first renewal group and initially had until June 30 deadline to complete paperwork. There's always a learning curve for the first group, so Harpstead moved to give them a one-month extension, a sensible measure that required federal officials to sign off on it. Other adjustments and flexibility may also be necessary in months to come.

Those who do end up losing coverage may be eligible for financial assistance to buy a private health plan on MNsure. For more information, go to tinyurl.com/4ycs8kbr. DHS also has online resources, including a tool for enrollees to check to see what renewal group they're in and determine the paperwork return deadline. It's available at mn.gov/dhs/renewmycoverage.

Minnesota's handling of this daunting health care challenge is putting a priority on keeping people insured. That stands in welcome contrast to other states where there's a lamentable rush to cut off coverage, even for those who still qualify for this vital assistance.