Who lost Med QUEST coverage after continuous enrollment ended

The end of pandemic Medicaid enrollment protections required Hawaii to resume eligibility reviews for people whose coverage had continued without the usual renewal cycle. This paper examines who lost coverage and what public records can establish about why. Federal review data reported by the Government Accountability Office show that most recorded Hawaii disenrollments in the studied period were classified as procedural rather than findings of ineligibility. That distinction matters because an incomplete renewal does not establish that a person no longer qualified. Hawaii also paused eligibility disenrollments during the remainder of 2023 after the Maui fires, subject to stated exceptions. Early local reporting described renewal problems alongside the state's explanation that some departures reflected income changes or other insurance. These sources concern different dates and populations. They cannot be combined into a single undated count of uninsured people. The paper distinguishes enrollment loss, a procedural closure, a later reinstatement, and a transition to other coverage. It recommends linked outcome reporting while avoiding unsupported claims about the eligibility or health outcomes of every person removed.