Millions Face Medicaid Loss When COVID PHE Ends


The COVID Public Health Emergency (PHE) ends in mid-May and could adversely impact healthcare insurance for millions of Americans.

The PHE extended Medicaid eligibility allowing millions to receive healthcare insurance. However, a little-publicized change about the PHE ending is that roughly 18 million will lose their Medicaid coverage. As of April 1, 2023, states can begin disenrolling persons receiving Medicaid under the pandemic-related Medicaid continuous coverage requirement. Without knowing that their coverage might end, Medicaid recipients won’t be able to take the necessary steps to maintain coverage or obtain new coverage if they are no longer eligible for Medicaid.

The Robert Wood Johnson Foundation conducted a survey in December 2022 to determine how aware Medicaid enrollees were that they might lose their Medicaid coverage after the Public Health Emergency ends. But beginning April 1st (before the end of PHE), states can return to regular Medicaid renewal processes, including disenrolling recipients who no longer qualify for the program.

  • 3% of adults receiving Medicaid hadn’t heard anything at all regarding a resumption in regular Medicaid renewal processes
  • 16% reported that they had heard a little
  • 9% said they had heard some
  • 1% had heard a lot

Their study also discovered that lack of awareness was evenly distributed throughout the country — regardless of geographic area, their state’s Medicaid expansion status, or what kind of Marketplace in each state. Lack of awareness was over 60% in all 4 geographical regions.

  • 6% – Midwest
  • 5% – Northeast
  • 4% – South
  • 3% – West

Awareness was also low as to whether the state had adopted the Affordable Care Act’s Medicaid expansion or whether they had federally-affiliated or state-based marketplaces. The study explained, “Awareness did not vary widely by state characteristics, which suggests the need for widespread outreach and education efforts.

“For example, in non-expansion states, where eligibility for continuing Medicaid is more limited for adults due to low eligibility thresholds, people will need help learning about and navigating Marketplace options; in expansion states, information about how to stay enrolled will be critical. In both types of states, unwinding may be more challenging when Medicaid and Marketplace enrollment systems are not well integrated.”

With so little time remaining until April 1, dissemination of this critical information is imperative at the state level — “to ensure states follow federal rules and offers states additional guidance on promoting coverage continuity.”

The Robert Wood Johnson Foundation ends with this recommendation, “Minimizing increases in uninsurance during unwinding will also likely require engaging community organizations and navigators to help people complete renewal processes or obtain other coverage that may be available.”