The number of Hawaii residents on Medicaid has jumped 40% since the start of the COVID-19 pandemic. Half of the state’s children and about one-third of the total population are now covered by the government health insurance program for people with low income.

But with federal pandemic protections, which have contributed to the heightened numbers, set to end, thousands could find themselves kicked out of the program. Hawaii’s Department of Human Serv­ices says it’s working to ensure that residents are aware of renewal requirements or know how to find alternative health insurance if they no longer qualify for Medicaid.

“We are trying to make sure that it is as seamless and as least disruptive as possible,” said Judy Peterson, Medicaid director and administrator for DHS’ Med-QUEST division.

Hawaii’s soaring enrollment numbers have climbed steadily since March 2020 when the pandemic decimated the economy. The state’s unemployment rate hit a high of 24% in April 2020 and still stood at 9.3% by the end of the pandemic’s first year.

As thousands of Hawaii residents lost their jobs and employer-sponsored health care coverage, they turned to Medicaid. But even as people returned to work and the unemployment rate declined to about 4% by the end of 2021, Hawaii’s Medicaid enrollment continued to increase.

Peterson said that’s because the state was required to keep covering anyone who had Medicaid as of March 2020, regardless of income and other eligibility requirements. Under Congress’ Families First Coronavirus Act, Medicaid recipients could lose their Medicaid coverage only if they canceled their insurance with the state, died or if the state verified that they had moved out of state.

Typically, Medicaid recipients have to renew their coverage annually, and people drop out if they don’t meet income requirements or don’t turn in their renewal paperwork.

“We had a lot of people applying for Medicaid and then they’re not being dropped, so that combination of things did lead to this huge increase,” she said.

Peterson said some people likely resumed their employer-based coverage when they went back to work but never contacted the state to ask that their Medicaid be discontinued, so they now have two sources of health insurance.

Despite the big jump in Medicaid enrollment, she said it hasn’t actually cost the state more, in part because the federal government increased its matching funds by 6.2 percentage points. Medicaid is funded by both the federal and state governments.

States are still waiting to find out when the continuous enrollment requirement, which is tied to the federal public health emergency, will end.

In the meantime, Peterson said residents seeking to continue their Medicaid coverage should make sure that her agency has their current contact information so that they’re made aware of deadlines and requirements for renewing coverage.