More than 81,000 Kansans have lost their Medicaid coverage as Kansas ends COVID-19 era extensions, according to data through the end of August released by the Kansas Department of Health and Environment Monday.

Nearly three-quarters of those Kansans lost their coverage because they failed to submit paperwork, not because they were deemed ineligible for the program that provides coverage to disabled and low-income Americans.

The loss in coverage comes as states across the country dismantle pandemic-era policies that allowed recipients to keep coverage longer without completing paperwork.

Before data began to become available state officials had predicted around 125,000 Kansans could lose coverage and that 100,000 of those would still be eligible if the state had expanded Medicaid. Kansas’ Medicaid program, called KanCare, has about 500,000 recipients. Thus far, of the 300,000 Kansans who have received renewal applications, more than 22,000 Kansans have lost coverage because they were no longer eligible.

Another 58,718 people have had their coverage temporarily discontinued because they did not return the form. Those individuals have 90 days to return the application and if they are approved their coverage will be backdated.

Kansas is one of 10 states that has refused to expand Medicaid since the program was first approved under the Affordable Care Act. Democratic Gov. Laura Kelly has offered a bill to expand the program every year since she became governor in 2018 but has been consistently thwarted by a GOP-controlled Legislature.

Last year Congress passed a budget bill requiring states to once again verify the eligibility of recipients – a process that’s being called the “unwinding” as participants are kicked off. For months, health officials have been scrambling to get the word out to enrollees to give them time to prepare and, if possible, look for alternative coverage.

Earlier this year, Kansas temporarily paused the unwinding process in response to a high number of Kansans being kicked off the program because of incomplete paperwork. Monday’s data shows that, even after the process restarted, that problem has persisted.

April Holman, executive director of the Alliance for a Healthy Kansas, a group that advocates for Medicaid expansion, said she’s been concerned by the results.

Holman said Kansas has been harmed by statutes that keep the state from issuing automatic renewals that have helped other states keep recipients enrolled. Holman said she’d like to see the Legislature act to fix that when they return next year.

In the meantime, she said, more work is needed to make sure Medicaid recipients know to watch for their renewal applications.

“We really just want people to know that they really need to do this,” she said. “They might be out of practice or they’re new to this altogether”