Millions to Lose Coverage During the ‘Unwinding’

Peter White | Ethnic Media Services

During 12 months after April 1, 2023, between 15-18 million Americans will lose health coverage provided during the COVID-19 pandemic by the Families First Coronavirus Response Act.

“Through COVID legislation, states have mostly kept people covered through Medicaid without interruption in exchange for an increase in their Medicaid federal matching funds,” says Farah Erzouki, Senior Policy Analyst, Center on Budget and Policy Priorities (CBPP). She spoke to reporters during an Ethnic Media Services briefing co-sponsored by CBPP last week.

When that program ends, so will the continuous coverage requirement, and all 89 million Medicaid enrollees will have to reapply to renew their eligibility. Erzouki says enrollment in Medicaid grew to 89 million-plus people since February of 2020, an increase of 30%. It was the biggest experiment in universal health care since the 2010 Affordable Care Act (ACA) was passed in 2010.

“Access to coverage and healthcare services has been critical during this time of increased hardship. At the same time, this continuous coverage policy has meant that most Medicaid enrollees probably have not had contact with their Medicaid agencies in three years, and in some cases, even longer,” she said.

Erzouki said that people would have to do the paperwork in order to keep their medical coverage. People have moved during the pandemic or may not receive their renewal notice in the mail.

Erzouki said in the coming months Medicaid agencies are going to be overwhelmed processing cases and documents. She estimated seven million people could lose their coverage due to paperwork issues although they are still eligible.

“They need to make sure that their Medicaid agency has updated contact information for them,” said Laura Guerra-Cardus, CBPP’s Director of State Medicaid Strategy.

Centers for Medicare and Medicaid have dubbed the end of expanded health coverage an “Unwinding.”

The Biden Administration could extend the date of the Public Health Emergency (PHE) for another 90 days and the continuous coverage requirement would remain for another three months. However, at some point it would end.

The Centers for Medicare and Medicaid Services (CMS) projects that some 8.2 million Medicaid recipients who reapply will no longer qualify and will have to transition to another source of coverage. Another 6.8 million will lose Medicaid coverage despite still being eligible.

“Check your mail,” says Guerra-Cardus. People could receive letters at some point from either Medicaid or CHIP and they should complete the renewal forms if they get one, she says. If they don’t qualify, they may be able to get affordable coverage through the Affordable Care Act marketplace and can learn more by visiting

“However, people are given a pretty limited time after they lose Medicaid coverage to transition to the ACA. So, the concern there is that people won’t have enough time to enroll in the marketplace after they lose Medicaid coverage without experiencing some sort of gap in coverage,” she said.

Eligibility and income requirements vary widely by state. So, contacting non-profit groups can help you fill out state-specific applications forms. For local help filling out an application go to:






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