What Is ‘Medicaid Unwinding’? As Millions of Americans Are Disenrolled, Here’s How You Can Act

More than 3.2 million people have been disenrolled so far. A healthcare finance expert explains what to know.

If you’ve found yourself struggling to navigate our healthcare system, you’re far from alone. Maybe you’re trying to figure out why you’re receiving a bill, pay the high cost of a prescription medication, or find a provider in your area. Even though the US is one of the wealthiest and most powerful countries in the world, our health outcomes remain some of the worst…and our healthcare is the most expensive. Whether you’re rich or poor, insured or uninsured, we are all trying to understand the opaque—and seemingly random—rules that impact our access to care.

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Now, millions of adults and children are facing the potential loss of Medicaid because the COVID-19 public health emergency has ended. For three years during the official pandemic, everyone approved for Medicaid had continuous coverage. If you got it, you kept it—no renewals needed.

Medicaid enrollment snowballed to nearly 100 million people by February 2023. States were allowed to resume eligibility reviews on April 1, and now the ball is being unraveled. This is known as Medicaid Unwinding. As Medicaid returns to a new normal, an estimated 8 million to 24 million Americans are expected to lose coverage over the next year.

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What is Medicaid?

Medicaid is a public health insurance program that provides coverage for people with low incomes. Its component for kids is called the Children’s Health Insurance Program, or CHIP. Medicaid and CHIP are jointly funded by the federal government with states and territories. The U.S. government sets guidelines, but each state or territory operates its unique program. Medicaid expansion—the Affordable Care Act provision that made the program available to people with higher incomes—has been adopted in 40 states and the District of Columbia. In addition to doctor’s visits and prescriptions, Medicaid covers many other non-clinical needs that help people achieve and maintain good health.

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What’s happening now with Medicaid Unwinding?

More than 3.2 million people have been disenrolled, according to early data from 35 states and analysis by Kaiser Family Foundation. This is an important benchmark to note because the unwinding will continue through summer 2024 in most states.

The publicly available numbers tell a frightening story. In Florida, about 302,000 people have been dropped from Medicaid—mostly because they didn’t respond to requests for information. Florida also dropped people who had not used their Medicaid in a year or more. In Arizona, one of the five states that started disenrollments in April, roughly 150,000 people have lost coverage.

Nationwide, about 75% of disenrollments have been due to procedural reasons, such as paperwork. The Associated Press reported that the chaos prompted the Biden Administration to ask states to slow down because many people still qualify but are “unnecessarily losing coverage” for procedural reasons.

What can I do to keep my coverage?

If you or your children have Medicaid or CHIP, it’s time to take action. If your Medicaid agency can’t reach you when it’s time to renew, you could lose coverage. Take a moment now to update and confirm your mailing address as well as other contact information. If your state or territory has an online self-service portal, sign up for an account. If you have an account, make sure you know your log-in information. If your state sends electronic alerts, sign up for text messages and emails. If you still qualify for Medicaid but can’t be reached, you’ll lose coverage for procedural reasons—even if you still qualify. If you’re confused, pick up the phone. States have toll-free numbers, extended call center hours, and more representatives to handle the Medicaid Unwinding.

The easiest way to get in touch with your Medicaid agency may be online, but many people don’t have internet access. States are addressing this digital divide. Georgia, for example, plans to install 400 kiosks in public libraries to help people in rural areas get online access to update their contact information and renew.

You can find Medicaid Unwinding information through GoodRx’s Medicaid resource hub for every state, Washington, D.C., and five U.S. territories: American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.

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What can I do if I’m disenrolled?

It’s important to note that if you miss your renewal deadline, you can typically send your information within 90 days of the due date and have your case reconsidered. If you are approved, your insurance will be reinstated to the date you lost coverage. You also have the option to reapply. In either case, you will be uninsured until your case can be reviewed.

If you are without coverage temporarily or you no longer qualify for Medicaid, you have other health insurance options. Your choices include a plan on the Affordable Care Act (ACA) marketplace, where you could qualify for a premium subsidy taking your costs as low as $10 a month. You can purchase a plan during the ACA unwinding special enrollment period from March 31, 2023 to July 31, 2024. If your spouse or partner has insurance, you could join their plan. You also may be eligible for health insurance at your job or through Medicare. If you need care right now and don’t have insurance, you may find free and low-cost care in your area. And always check for discounts on prescription medications with such growing resources as GoodRx.

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Cindy George
Cindy George has been a health journalist for more than a decade. At GoodRx, she serves as personal finance editor and works on stories about healthcare costs and coverage. Before GoodRx, Cindy was assistant editor of the Texas Medical Center’s magazine and online news operation. She was among the Houston Chronicle staff members listed in the entry honored as a 2018 Pulitzer Prize finalist for breaking news coverage of Hurricane Harvey. Cindy holds a bachelor’s degree in journalism from the University of Florida and is completing a master’s degree in public health from the University of Texas Health Science Center at Houston.