70% of Medicaid Coverage Losses Are Procedural, Costing Hospitals Billions

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May 11, 2026, 08:05 ET

Medicaid redeterminations are triggering widespread coverage loss among eligible Americans. AmeriTrust Solutions pinpoints the administrative barriers fueling churn, leaving patients uninsured, and shifting billions in costs to providers.

WASHINGTON, May 11, 2026 /PRNewswire/ -- As a country, the United States may have moved far beyond the COVID-19 pandemic, but a major part of the healthcare system is still feeling the aftermath. A Kaiser Family Foundation (KFF) analysis shows that of the estimated 16.4 million people who recently lost their Medicaid coverage, approximately 70% had their coverage terminated for procedural reasons. One snag in the system comes in the aftermath of "Medicaid unwinding," the process of restarting eligibility checks after pandemic-era continuous coverage protections ended. Technically, the unwinding period was set to end by mid- to late 2024. Operationally, states and Centers for Medicare & Medicaid Services (CMS) continue to grapple with the aftereffects of fixes, appeals, and a new crisis: coverage churn.

“When we get enrollment right at the start, we can keep patients covered, recover billions in lost revenue, and strengthen the entire healthcare system from the ground up,” - Peter Justen, founder and CEO of AmeriTrust Solutions

AmeriTrust Solutions warns that eligible patients are still being routinely dropped from Medicaid due to paperwork errors, incomplete applications, and complex renewal processes, all of which forces providers to absorb billions in uncompensated care.

"The biggest Medicaid problem right now isn't eligibility; it's keeping eligible people enrolled," said Peter Justen, founder and CEO of AmeriTrust Solutions. "When coverage breaks due to administrative errors, patients lose access, and providers are left holding the financial risk."

A Coverage Crisis Hiding in Plain Sight
The resumption of Medicaid redeterminations after the COVID-19 public health emergency has exposed operational flaws in the process. While intended to ensure program integrity, the transition process has disproportionately removed eligible individuals due to procedural issues. The consequences are immediate and widespread:

The American Hospital Association (AHA) reports hospitals delivered $42.4 billion in uncompensated care in 2022.
A significant share of this burden stems from patients who are Medicaid-eligible but unenrolled at the time of care.
Coverage instability leads to delayed treatment, poorer outcomes, and increased system costs.

For vulnerable populations, coverage churn creates a revolving door that interrupts and delays access to care even when eligibility remains unchanged.

Process Errors, Not Policy Design
Federal oversight agencies have flagged serious concerns about how states have implemented redetermination processes. The U.S. Government Accountability Office found that millions of individuals were disenrolled without full eligibility reviews, raising questions about the reliability of renewal systems.

Despite federal guidance promoting streamlined approaches like using existing data for renewals, execution remains uneven. According to the Commonwealth Fund, improving automated and simplified renewal processes is critical to reducing churn and maintaining continuous coverage.

Providers Bear the Financial Fallout
Coverage loss originates in administrative processes, but the financial impact falls squarely on providers. Hospitals, particularly rural facilities and safety-net providers, must continue delivering care regardless of coverage status. When eligible patients are uninsured, providers are unable to recover costs, driving up uncompensated care and eroding already thin margins.

KFF estimates one-quarter or more of uncompensated care may be tied to Medicaid-eligible patients, representing billions in lost reimbursement.

Fixing the Problem at the Front Door
AmeriTrust Solutions is addressing coverage churn at its source: the intake and enrollment process. By modernizing how eligibility is verified and applications are completed, the company helps keep eligible patients continuously covered. Its approach replaces manual, error-prone workflows with data validation and streamlined enrollment processes.

As policymakers shift focus from unwinding to long-term reform, coverage continuity is emerging as a central issue. Without meaningful improvements to enrollment systems, coverage churn will continue to:

Increase uninsured rates among eligible populations.
Drive higher uncompensated care costs.
Accelerate financial strain on rural and safety-net providers.

"When we get enrollment right at the start, we can keep patients covered, recover billions in lost revenue, and strengthen the entire healthcare system from the ground up," Justen said, calling for a coordinated effort to modernize Medicaid enrollment infrastructure and reduce administrative barriers to coverage.

"If we don't fix this now, coverage churn will remain one of the largest hidden cost drivers in healthcare," Justen cautioned. "The good news is this is a fixable problem. Improving enrollment accuracy at the front end is one of the most efficient ways to stabilize both patient coverage and provider finances."

About AmeriTrust Solutions
AmeriTrust Solutions is a Medicaid eligibility modernization company focused on improving enrollment accuracy at the point of intake. Built from lived experience navigating Medicaid bureaucracy and refined alongside rural hospitals and state eligibility operators, AmeriTrust Solutions integrates consent-based data verification into existing state systems without requiring full infrastructure replacement. By reducing documentation gaps and administrative friction, AmeriTrust Solutions helps protect public funds, stabilize hospital revenue cycles, and strengthen compliance defensibility under federal oversight. Visit https://ameritrustsolutions.com/.

Sources

Kaiser Family Foundation. (2024). An examination of Medicaid renewal outcomes and enrollment changes at the end of the unwinding.
Kaiser Family Foundation. (Updated Monthly since 2024). Medicaid enrollment and unwinding tracker.
American Hospital Association. (2024). Uncompensated hospital care cost fact sheet.
Centers for Medicare & Medicaid Services. (2024). Renewal strategies and tools.
Gunja, M. Z., et al. (2025). Reducing Medicaid churn: Policies to promote stable health coverage. Commonwealth Fund.
U.S. Government Accountability Office. (2025). Medicaid and CHIP: Disenrollments during unwinding raise concerns about eligibility processes (GAO-25-107413).