Key TakeawaysAs many as 20 million people will lose their eligibility for Medicaid coverage when the COVID-19 pandemic public health emergency. Eligibility for the Children’s Health Insurance Program (CHIP) will also be affected.During the pandemic, the federal government required that state Medicaid programs keep people enrolled even if they would normally have lost eligibility for any reason.Many people who will lose Medicaid should be able to get low-cost health insurance through the federal and state insurance marketplaces.
Key Takeaways
As many as 20 million people will lose their eligibility for Medicaid coverage when the COVID-19 pandemic public health emergency. Eligibility for the Children’s Health Insurance Program (CHIP) will also be affected.During the pandemic, the federal government required that state Medicaid programs keep people enrolled even if they would normally have lost eligibility for any reason.Many people who will lose Medicaid should be able to get low-cost health insurance through the federal and state insurance marketplaces.
On May 11, 2023, the COVID public health emergency will officially end. Declaring the state of emergency over will come as a relief to many, but not the millions of people onMedicaid—many of whom will lose theireligibility.
Medicaid & CHIPMedicaidis a federally-funded program to make sure that people who are poor and/or disabled have health care coverage.CHIPprovides low-cost health coverage for kids in families that earn too much money to qualify for Medicaid but that cannot afford to buy private insurance.
Medicaid & CHIP
Medicaidis a federally-funded program to make sure that people who are poor and/or disabled have health care coverage.CHIPprovides low-cost health coverage for kids in families that earn too much money to qualify for Medicaid but that cannot afford to buy private insurance.
Here’s what you should know if you’re on Medicaid and/or CHIP and are worried about losing your coverage.
How to Get Health Insurance
Why Is the End of the Pandemic Affecting Medicaid?
At the beginning of the COVID pandemic, Congress enacted the Families First Coronavirus Response Act. It gave states moremoney for Medicaidbut required them to keep people continuously enrolled in Medicaid programs through the end of the public health emergency.
Starting on April 1, states will be able to terminate Medicaid for people who are no longer eligible for it.
How Many People Will Lose Medicaid?
Kate McEvoy, JD, the executive director of the National Association of Medicaid Directors, told Verywell that more than 90 million people are currently Medicaid beneficiaries. According to theKaiser Family Foundation(KFF), that’s a nearly 28% increase in Medicaid enrollment compared to February 2020,
McEvoy said that an estimated 15 to 20 million of those people could lose their eligibility with the changes that are coming. KFF estimates that between 5 and 14 million people could lose their Medicaid coverage.
According to McEvoy, people on Medicaid usually only lose their eligibility if their income goes up or there is a change in their disability status. Most current Medicare recipients will still be eligible—especially older adults and disabled people who tend to have stable life circumstances and incomes.
State Medicaid programs serve between 25% and 30% of their populations but vary in their eligibility requirements. For example, McEvoy noted that some states have higher limits on income.
How Do Health Insurance Exchanges Work?
Will Anyone Benefit From the Changes?
Ge Bai, PhD, CPA, a professor of accounting at the Carey Business School and a professor of health policy and management at the Bloomberg School of Public Health at Johns Hopkins University, told Verywell that the changes are good news for taxpayers, who have been “subsidizing more than their fair share to the COVID pandemic.”
Bai said that the unwinding will not affect most Medicaid recipients because the only reason they stayed eligible for Medicaid in the first place was because of the pandemic.
While Bai said that making sure more people had access to healthcare—including vaccines and COVID testing—was necessary “to help prevent the pandemic from spreading at its original speeds,” now, the “time has changed and so our policy must change.”
What’s the Timeline for the Medicaid Changes?
A spokesperson for CMS told Verywell that the continuous enrollment condition will end on March 31, 2023, the temporary increase in Medicaid funding will be gradually reduced and phased out starting on April 1, 2023, and it will come to an end on December 31, 2023.
For more information about the transition after the end of the public health emergency, you can learn more from the Department of Health and Human Services (HHS)fact sheet.
McEvoy said that these changes in Medicaid coverage have not been unexpected and planning for them has been underway. In fact, some changes have already started.
“It was always known and anticipated that at the end of the pandemic, states would resume their historically typical eligibility determinations,” said McEvoy.
CMS alsoreleased informationfor states who might need more time or help with the process—for example, if they’re having a hard time figuring out which enrollees will continue to be eligible in part because they don’t have enough people working for them or their ancient computer systems can’t keep up with the demand.
According to the spokesperson, people who remain on Medicaid will still have coverage for COVID vaccines, testing, and treatment until September 30, 2024—more than a year after the public health emergency ends.
How Obamacare Subsidies Work
What Should You Do If You’re Going to Lose Medicaid?
About 8 million people who will lose their Medicaid are expected to be eligible for another source of health coverage—for example, through state and federal health insurance marketplaces or their employers.
ObamacareThe Affordable Care Act (Obamacare) set up insurance marketplaces so that people could find and sign up for affordable health insurance plans. The federal health insurance marketplace is atHealthcare.gov.
Obamacare
The Affordable Care Act (Obamacare) set up insurance marketplaces so that people could find and sign up for affordable health insurance plans. The federal health insurance marketplace is atHealthcare.gov.
“The best first step is to contact their Medicaid office and make sure that office has their current contact information,” said McEvoy. “Include a cell phone number and an email so that the state will have every possible means of getting in touch with them around their eligibility status.”
To help people who will loseMedicaid or CHIPeligibility, the CMS spokesperson said there will be temporaryspecial enrollment periodsin addition to the annualopen enrollment period.
If a person gets a notice about their Medicaid eligibility, McEvoy said the state program will also be trying to connect them with other sources of health insurance, like the marketplaces. CMS will also try to partner with healthcare systems and clinics to help get to patients.
According to Bai, the people who will lose theirMedicaideligibility would have lost coverage or been unable to obtain it if the pandemic emergency provisions had not been in place.
While some people will be able to adjust, it could be more challenging for others. Even with outreach, people who don’t speak English fluently and disabled people are likely to be at an even higher risk of losing coverage if these attemptsaren’t accessibleto them.
If you’ll lose Medicaid and you’re not sure if you’ll be able to get coverage through the marketplace, you canreach out to them directlyfor help. You can also check with your employer or your partner’s employer to find out if you might be eligible for coverage.
What This Means For You
As many as 20 million people may lose their eligibility for Medicaid or CHIP in the coming months as the COVID public health emergency ends.
If you’re on Medicaid, make sure that your state program has at least two ways to contact you, such as your phone number, email, or mailing address.
1 SourceVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Department of Health and Human Services.Unwinding the Medicaid continuous enrollment provision: projected enrollment effects and policy approaches.
1 Source
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Department of Health and Human Services.Unwinding the Medicaid continuous enrollment provision: projected enrollment effects and policy approaches.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Department of Health and Human Services.Unwinding the Medicaid continuous enrollment provision: projected enrollment effects and policy approaches.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
