Here's What To Do If You'll Lose Medicaid Coverage When the Pandemic Emergency Ends

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 on Medicaid—many of whom will lose their eligibility.

Eligibility for another program, the Children’s Health Insurance Program (CHIP), could also be affected by the end of the pandemic emergency.

Here’s what you should know if you’re on Medicaid and/or CHIP and are worried about losing your coverage.

Why Is the End of the Pandemic Affecting Medicaid?

The process of returning to normal Medicaid operations after the COVID emergency is being called “the unwinding” by the Centers for Medicare and Medicaid Services (CMS). States will have up to 12 months to return to normal eligibility and enrollment operations.

At the beginning of the COVID pandemic, Congress enacted the Families First Coronavirus Response Act. It gave states more money for Medicaid but 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 the Kaiser 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.

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.

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.

The spokesperson said that CMS is working with state agencies and other federal agencies to prepare for the end of the continuous enrollment condition by holding regular workgroups, conference calls, and technical assistance. CMS has also created a website to help people understand the process.

CMS also released information for 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.

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.

“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 lose Medicaid or CHIP eligibility, the CMS spokesperson said there will be temporary special enrollment periods in addition to the annual open 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 their Medicaid eligibility 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 attempts aren’t accessible to them.

If you’re on Medicaid and/or CHIP, do what you can now to prepare for losing coverage. You can start by contacting your state Medicaid program to check your eligibility if you haven’t heard from them already.

If you’ll lose Medicaid and you’re not sure if you’ll be able to get coverage through the marketplace, you can reach out to them directly for help. You can also check with your employer or your partner’s employer to find out if you might be eligible for coverage.