Medicaid disenrollments can restart in April after three years of continuous coverage

Early in the COVID-19 crisis, states paused Medicaid disenrollments to keep people from losing health coverage during the pandemic. This continuous enrollment protection ends on March 31, and millions of people could lose coverage, including children and adults who remain eligible but get dropped from the rolls due to procedural reasons. OT practitioners can help minimize coverage losses by encouraging clients who rely on Medicaid to make sure their contact information is up to date and respond quickly to communications about their health insurance.

Unwinding continuous enrollment protections

More than 90 million people are enrolled in Medicaid and CHIP, an increase of almost 30% since the start of the pandemic, thanks in large part to a 2020 COVID-19 relief law that offered states a 6.2% increase in federal Medicaid funding on the condition that they keep people continuously enrolled during the public health emergency (PHE). Congress delinked the continuous enrollment requirement from the PHE late last year, giving states permission to start removing people from the rolls on April 1, and phasing down the funding boost through 2023. The return to normal operations will require states to conduct a fresh eligibility check for all Medicaid enrollees and remove those who no longer qualify, a process health policy experts are calling “unwinding.” States can take as long as 12 months to initiate renewals, and an additional two months to complete them, but some states will move quicker.

The U.S. Department of Health and Human Services (HHS) projects that 15 million people will lose Medicaid coverage after the continuous enrollment protections are lifted, including millions of people who remain eligible but lose coverage because of administrative obstacles like missed mailings.

Minimizing coverage gaps

OT practitioners can help prevent interruptions in care by encouraging people who rely on Medicaid to take these steps:

• Update your contact information. Make sure the state Medicaid agency knows your current mailing address, phone number, and e-mail so they can contact you with important information about your health insurance.
• Get ready to renew your coverage. Medicaid is restarting regular eligibility checks. Be on the lookout for letters, e-mails, calls, or text messages from Medicaid, and respond quickly to requests for information.
• Know your options if you are no longer eligible. You may be able to get zero- or low-premium health insurance from your state’s Affordable Care Act (ACA) Marketplace. Kids may be able to move to Children’s Health Insurance Program (CHIP) coverage.

Finding resources

• States have publicly available resources like unwinding plans or summaries, provider toolkits, and data dashboards.
• The Centers for Medicare and Medicaid Services (CMS) Unwinding and Returning to Regular Operations After COVID-19 page has an array of resources including state guidance and messaging toolkits.