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.1 These periods, ranging from 3 to 12 months, are called lockouts, noneligibility periods, or restrictive reenrollment periods. Discontinuous Medicaid coverage is linked to poor access,2,3 but the effects of temporary, short-term lockouts are unknown. Wisconsin received a Section 1115 waiver allowing the application of premiums enforced by lockouts among adults receiving transitional medical assistance (TMA),4 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.5 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. This survey study compared the demographic characteristics, access to care, and health status of recent Medicaid enrollees with and without lockout experience.