Preparing for the Biggest Coverage Event Since the ACA: The Role of States as Medicaid Continuous Coverage Comes to an End


Georgetown University’s Center on Health Insurance Reforms (CHIR) and the Center for Children and Families (CCF) have published two new resources examining state-level preparations for the end of the COVID-19 public health emergency and the redetermination of the Medicaid eligibility of close to 85 million people. Although the date of the end of the public health emergency is uncertain, many observers expect the Biden administration to extend it just one more time and allow it to expire in less than four months (most likely mid-July, 2022). This is not much time for state officials to take the necessary steps to ensure that the estimated 16 million people expected to be disenrolled from Medicaid do not lose access to health insurance coverage and essential services.

Perspectives from State Health Officials on the End of Medicaid’s Continuous Coverage Requirement

A new issue brief from researchers at CHIR and the Urban Institute examines the planning that state-based Marketplaces and their counterparts in state Medicaid agencies are undertaking to prepare for the end of the public health emergency and the continuous enrollment provisions. Researchers conducted structured discussions with Marketplace and Medicaid officials in 11 states to get an understanding of planning efforts, best practices, and risks associated with the impending coverage transitions.

How well integrated Medicaid and Marketplace agencies are, how much planning is taking place, and how agencies coordinate data sharing and outreach strategies vary significantly across states. State officials outlined ways in which they are working to overcome several challenges, including lack of lead time, workload and staffing challenges, lack of data, technology glitches, and market instability. Several states are pursuing innovative strategies to mitigate coverage loss and ease consumers’ transitions into alternative sources of coverage.

You can read the full brief here.

Medicaid and CHIP Eligibility and Enrollment Policies as of January 2022: Findings from a 50-State Survey

The 20th annual survey of state Medicaid and Children’s Health Insurance Program (CHIP) officials conducted by KFF and Georgetown’s CCF in January 2022 presents a snapshot of actions states are taking to prepare for the lifting of the continuous enrollment requirement, as well as key state Medicaid enrollment and renewal procedures in place during the PHE.

The survey suggests that many state Medicaid agencies have not yet adequately prepared for the resumption of eligibility redeterminations and renewals. Several states are contemplating an accelerated process that could increase the risk that people will be disenrolled in error or solely for administrative reasons, such as an untimely response to a request for information. Furthermore, while a healthy majority of states plan to increase their staffing capacity to adjust to the increased workload, many are not, making it more likely that consumers will face overwhelmed case workers and call centers. On average, state Medicaid agencies are reporting that 13 percent of those currently enrolled in their programs will be disenrolled.

You can read all the findings from the 50-state survey here.





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