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KFF Analysis: Unwinding Medicaid’s Continuous Enrollment Provision

January 27, 2023

New analysis from the Kaiser Family Foundation (KFF) projects that millions of Americans could lose health coverage with the upcoming unwinding of Medicaid’s pandemic-era continuous enrollment provision.

The analysis, released this week, reviews 2016–2019 data from Medical Expenditure Panel Survey to project how Medicaid will change in the coming months.

Here’s what you need to know:

  • Background:  At the outset of the pandemic, the Families First Coronavirus Response Act included a requirement that Medicaid programs keep people continuously enrolled in exchange for enhanced federal funding
    • The continuous enrollment provision expires on March 31, 2023
  • By the numbers:  KFF estimates between 5 and 14 million people will lose Medicaid coverage when continuous enrollment ends
  • Historical perspective:  Based on pre-pandemic data, about 65 percent of people who disenrolled from Medicare/Children’s Health Insurance Program (CHIP) had a period without insurance for all or part of the year that followed
  • Re-enrolling:  About 41 percent of people who disenrolled in Medicaid or CHIP re-enrolled within a year, a process known as “churn”
    • Another 26 percent found another source of coverage for a year and 17 percent were uninsured for the full year
  • Quotable:  “Although our analysis provides a pre-pandemic baseline for peoples’ health insurance changes after losing Medicaid/CHIP coverage, state policies for the unwinding will have a major impact on whether people will be more successful in transitioning to other coverage after losing Medicaid compared to pre-pandemic trends,” the analysis concludes.

KFF notes that the federal government has released reporting requirements and guidance to reduce coverage disruptions after the continuous enrollment period ends.

HAP continues to monitor the unwinding of the continuous Medicaid enrollment in Pennsylvania and will provide updates to members.

The KFF analysis is available to review online.