Beginning April 1, 2023, states can start disenrolling people from Medicaid for the first time since March 2020. A recent Urban Institute survey found that many people are not aware of upcoming changes.

Currently, people who were enrolled in Medicaid at the beginning of the COVID-19 pandemic are largely still enrolled. A pandemic-related law suspended routine redeterminations of Medicaid eligibility and prevented states from disenrolling most people with Medicaid, even if they had changes in their circumstances that would ordinarily disqualify them from benefits.

The Consolidated Appropriations Act (CAA) set the April 1 date for unwinding these pandemic protections and allows states to resume their regular renewal and redetermination processes. But people who are unaware of the change may be unprepared to complete the paperwork and other steps needed to maintain coverage if they are still eligible, or to explore other options for coverage if they are not.

The Urban Institute completed a survey in December 2022 that found that 64% of adults in Medicaid-enrolled families were totally unaware of the upcoming return to regular Medicaid processes. Only about 5% of people had “heard a lot” about the changes, and the remaining 30% were almost equally divided between those that had heard “some” or “only a little” about the changes. This low level of awareness was consistent across the country – although awareness was slightly lower in the northeast, with 66.5% of respondents reporting that they had heard nothing about the proposed changes. All regions had at least 60% of respondents reporting a complete lack of awareness. Medicaid expansion status and the type of marketplace utilized for Affordable Care Act plans did not make any significant difference.

The survey results do not indicate whether people enrolled in both Medicare and Medicaid are any more or less aware of the upcoming changes. Regardless, the need for robust education and outreach is clear. State Medicaid offices must also be prepared for potentially high volumes of questions. As much as possible, CMS and states should implement flexible processes and accommodations and review procedures to eliminate gaps in coverage and care disruptions for particularly vulnerable populations.

Read the report.