A Medicaid Protection Expires Saturday, Threatening Coverage For 15 Million

The U.S. government projects 15 million people could lose Medicaid or CHIP coverage as states unwind the continuous enrollment provision.
Alice Morgan/Investopedia.

Starting on Saturday, millions of people enrolled in Medicaid will have to re-enroll in the program or lose their healthcare coverage as a federal rule protecting them expires.

During the pandemic, people on Medicaid, the government’s health insurance program for people with low incomes or disabilities, got a break. The federal government banned states, which administer the program, from kicking beneficiaries off the rolls unless they moved out of state or died. 

The so-called continuous enrollment provision comes to an end April 1, when states will begin a 14-month-long process of canceling Medicaid coverage for people who aren’t eligible for one reason or another.

It’s not all happening at once, and the process is different in every state. People on Medicaid can check their state’s Medicaid website to see what they have to do to stay covered.

Determining who is still eligible for Medicaid is a mammoth bureaucratic task. More than 92 million Americans—about 1 in 4 people—get health insurance through Medicaid or the related Children's Health Insurance Program. 

The number  of Medicaid recipients increased by 20.2 million during the pandemic. That drove the nation’s uninsured rate to a record low 8%, mostly because of the continuous enrollment rule that stopped people from losing their coverage, research suggests.

Each state has its own rules for who can get Medicaid and what they will have to do to stay enrolled, typically requiring renewal every year.  People can lose their coverage if they become ineligible, for example by earning too much money

Many people lose coverage every year even when they’re eligible. Common reasons for this include not being able to provide documentation, not receiving notice through the mail, or paperwork getting lost in government offices, Tricia Brooks, a professor at Georgetown University who studies health policy, wrote in a blog post.

The Department of Health and Human Services estimates that 15 million people will lose Medicaid benefits as the continuous coverage provision is unwound. Of those, 6.8 million will likely be disenrolled despite still being eligible. 

Among those losing Medicaid coverage, some will be able to re-enroll, some will be able to get health insurance through Obamacare or through employer-provided health plans, but others will not. Among people who were disenrolled from Medicaid in the past, about 17% still didn't have health insurance a year later, a Kaiser Family Foundation analysis found.

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  1. Department of Health and Human Services. "Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023."

  2. Medicaid. "December 2022 Medicaid & CHIP Enrollment Data Highlights."

  3. JAMA Network. "Changes in US Medicaid Enrollment During the COVID-19 Pandemic."

  4. Department of Health and Human Services. "Unwinding the Medicaid Continuous Enrollment Provision:

    Projected Enrollment Effects and Policy Approaches."

  5. Georgetown University. "As the Medicaid Continuous Coverage Protection Ends This Week, It’s Important to Understand Procedural Disenrollments and Why They Occur."

  6. Department of Health and Human Services. "Unwinding the Medicaid Continuous Enrollment Provision:

    Projected Enrollment Effects and Policy Approaches."

  7. Kaiser Family Foundation. "What Happens After People Lose Medicaid Coverage?"

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