Medicaid’s Great Unwinding

In March 2020, when the pandemic was in its full fury, the federal government took emergency measures that prohibited states from removing people from the Medicaid program. In exchange, the states were given increased federal Medicaid funding.

More than 23 million people were added to Medicaid and the Children’s Health Enrollment Program (CHIP), reaching 95 million at the end of March 2023 (Kaiser Family Foundation, KFF).

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But on April 1, 2023, the emergency provision of continuous enrollment ended and what has been called “the great unwinding” of people on Medicaid began. This means that states could once again apply their own rules for Medicaid eligibility, which vary considerably. States have been able to disenroll people who no longer qualify or who face barriers to completing the renewal process.

Nationally, millions of people are expected to lose this critical healthcare insurance coverage for low-income families. Forty-four states and the District of Columbia have reported disenrolling over 4.8 million Medicaid enrollees as of August 17. The disenrollment rate ranges from 72% in Texas to 8% in Wyoming. Pennsylvania’s rate is 33%.

Ineligibility is tied to a state’s income level requirements. Among those disenrolled nationally, however, 71 percent were terminated for procedural reasons due to not completing the renewal process. (Source: KFF and the Medicaid Enrollment and Unwinding Tracker)

In Pennsylvania, as of last May, about 44 percent of those terminated were for procedural reasons, and 56 percent were determined ineligible.

Unfortunately, many people on Medicaid are unaware of the implications of the Medicaid unwinding (or even that it is happening) and some may have unknowingly lost coverage. Everyone who has benefited from Medicaid needs to check on their status.

Pennsylvanians who no longer qualify for Medicaid may be able to enroll in one of PENNIE’s programs. (PENNIE is Pennsylvania’s own healthcare exchange on the Affordable Care Act (ACA).

If you need advice regarding your status or help re-enrolling in either Medicaid or PENNIE, please call the Pennsylvania Health Access Network (PHAN) at 877-570-3642.

Jeanne Duffy, Ph.D., has served as a college professor, an analyst and project manager for several large companies, and a college administrator in charge of foundation and government support. She is on the Steering Committee of Gettysburg Democracy for America and a member of its Government Accountability and Healthcare task forces.

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