The Alabama Medicaid Agency recently released a report showing that a total of 278,238 Alabamians lost Medicaid coverage from June 2023 to June 2024. This decline in enrollment is attributed to the expiration of pandemic-era federal protections, leading to a process known as Medicaid unwinding.
The report indicates that as of the end of June, there were approximately 1.1 million Alabamians enrolled in Medicaid, a significant decrease from the state’s peak enrollment of nearly 1.4 million in June 2023. The decrease in enrollment was observed across various counties in Alabama, with Jefferson County seeing a drop of 35,151 Medicaid recipients, followed by Mobile, Madison, and Montgomery Counties.
Nationally, more than 25 million Americans have lost Medicaid coverage during the unwinding process. The reasons for losing coverage vary, including members no longer being eligible due to increased income, moving out of state, or procedural reasons.
The report also breaks down the demographics of Medicaid enrollment changes, showing decreases in both Black and white Alabamians, as well as in children, adults, and women. Despite these reductions, Alabama has among the lowest rates of uninsured children due to alternative state programs like ALL Kids.
State lawmakers have been exploring the possibility of expanding Medicaid through a private-public partnership model, but Gov. Kay Ivey has expressed concerns over costs. The Alabama Medicaid Agency was allocated $955 million from the state General Fund for fiscal year 2025, making it the largest expense for the fund.
Overall, the decline in Medicaid enrollment in Alabama reflects the challenges faced by individuals and families as federal protections expire, leading to a reassessment of eligibility for the program.
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