Concern over lagging vaccination rates among Medicaid beneficiaries has prompted two Democratic leaders to request a study from the Government Accountability Office on potential barriers to vaccination.
Sens. Bob Casey (D-PA), chairman of the Senate Special Committee on Aging, and Ron Wyden (D-Oregon), chairman of the Senate Committee on Finance, asked for the study Friday in a letter to the GAO. They raised concerns that data barriers could impede efforts to increase COVID-19 vaccination rates and address persistent health inequities in older adults, communities of color and low-income individuals.
The legislators cited an analysis from the Center on Budget and Policy Priorities that an estimated 5 million frontline workers are enrolled in Medicaid, making it a “crucial source of coverage for individuals who have risked exposure to COVID-19 in order to maintain our nation’s economy, including the healthcare system and other critical services.”
Nationally, there is a 15% to 20% difference in COVID-19 vaccination rates between Medicaid beneficiaries and people enrolled in other forms of health coverage, according to Duke University researchers.
In a letter to the GAO, the legislators also cited various reports from Kaiser Health News and RollCall identifying administrative and technologic barriers that block or limit access to data that would help Medicaid programs identify unvaccinated beneficiaries. Vaccine hesitancy and economic barriers — including lack of access to transportation, children care and sick leave — also lead to variations in vaccination rates, they said.
In California, for example, 49% of Medicaid enrollees aged 12 or more years were at least partially vaccinated, compared with 74% of Californians overall, according to those reports. Florida and Louisiana showed a 33 percentage point difference in vaccination rates between Medicaid enrollees and the general population, whereas Idaho reported a 40 percentage point difference, Virginia a 34 percentage point difference and West Virginia a 28 percentage point difference.
“A lack of good data hurts our ability to get shots in arms, which can prolong the pandemic and put high-risk groups in even greater danger,” Casey and Wyden wrote. “Addressing the disparity in vaccination status for Medicaid enrolled and ensuring greater data sharing among different programs is, therefore, vital for protecting essential workers and for addressing health equity concerns related to the pandemic.”
Specifically, the senators asked the GAO to address factors contributing to lower Medicaid vaccination rates, determine how states used data to improve vaccination rates and address vaccination disparities, provide examples of state Medicaid programs that have no or limited access to vaccination data from their state immunization registries, call out differences in COVID-19 vaccination data across states, and identify federal support to improve vaccination outreach, uptake and data monitoring among Medicaid enrollees.