Many Medicaid and State Children’s Health Insurance Program (CHIP) beneficiaries lose coverage and subsequently re-enroll in the program within a short period of time, a phenomenon often referred to as churn. Temporary or long-term gaps in coverage can hinder beneficiaries from accessing preventive care, other needed care and treatment, and prescription drugs that are necessary for managing and treating health conditions.
This issue brief summarizes MACPAC’s analyses on the effects of churn on health service use among adult Medicaid beneficiaries using 2017-2019 national data from the Transformed Medicaid Statistical Information System. We examined the rates in emergency department (ED) visits and hospitalizations related to four ambulatory care-sensitive conditions (ACSCs) before and after experiencing a gap in coverage. We found that the rates of ED visits and hospitalizations related to these four ACSCs more than doubled in the first month after churning when compared to the baseline rate (established during the six months before an episode of churn). Further, the increase in rates of hospitalizations varied by length of coverage gap and by racial and ethnic group.