Administration health officials from the Centers for Medicare and Medicaid Services (CMS) on Tuesday said they were closely monitoring state data and were concerned about the high numbers of people losing coverage.

If states are not following federal law, officials said the agency would take action.

“When it is needed, we will not hesitate to use all of our enforcement tools to ensure that states are doing what they are required to do throughout the renewals,” CMS Administrator Chiquita Brooks-LaSure said on a call with reporters. 

Medicaid enrollment hit record high numbers amid the COVID-19 pandemic because states weren’t allowed to end coverage. But that safety net ended in April, and states started to determine — for the first time in three years — who was eligible for Medicaid.

In some states, more than 80 percent of people who lost coverage were due to what CMS described as “procedural reasons,” such as the failure to return forms.

In a letter to governors sent Monday, Health and Human Services Secretary Xavier Becerra decried the massive coverage losses and urged states to adopt all available flexibilities to minimize avoidable coverage losses among children and families.  

“I am deeply concerned with the number of people unnecessarily losing coverage, especially those who appear to have lost coverage for avoidable reasons that State Medicaid offices have the power to prevent or mitigate,” he wrote.

Officials on Tuesday urged governors to do more than the bare minimum to make sure those eligible retain their health coverage.

The administration is offering waivers and strategies and wants states to take advantage of them, especially ones that allow for auto-enrollment without any physical paperwork.  

Still, officials acknowledged that as long as governors are following federal law, the administration doesn’t have the power to force states to do anything.