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Medicaid Unwinding Extension as Eligible People Lose Access to Care

During the COVID-19 pandemic, states had the option to get increased federal funding for Medicaid if they agreed to place a hold on redeterminations until March 31, 2023. These continuous enrollment provisions meant that states did not assess enrollees’ eligibility to receive Medicaid, so people were not required to prove they continued to qualify for Medicaid coverage.

Starting in April of 2023, states could start resuming their redetermination processes, with an initial target date of June 2024 for completion of the “unwinding” process. Many experts and advocates worried that unwinding put access to Medicaid coverage for millions of people who were still eligible at risk. These fears were well founded, as KFF analysis of the early unwinding data showed that nearly 1.4 million people across 22 states lost Medicaid as of June 20, 2023. 71% of this population had their coverage terminated for procedural reasons, such as incomplete paperwork and outdated contact information.

The effect on some populations has been devastating. Native Americans, for example, have reported high levels of procedural disenrollments, leading to loss of coverage and access to care.

In an attempt to mitigate some of these issues, the Biden-Harris administration urged states in mid-2023 to slow their processes and avoid costly mistakes. But, to date, more than 21 million people have been disenrolled from Medicaid, with 69% being disenrolled for procedural reasons.

With an estimated one quarter of redeterminations still to go, the administration recently extended state access to waivers that ease the unwinding process to June 30, 2025. At Medicare Rights, we strongly support this extension and other actions from the administration and states to limit the use of procedural disenrollments and improve processes to avoid dropping eligible people from Medicaid coverage.

Read the notice of extension.

See the KFF Medicaid unwinding tracker.

Read more about the Medicaid continuous enrollment provisions and unwinding flexibilities.

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