Millions of People Could Lose Medicaid Coverage When the Pandemic Is Declared Over

While declining COVID-19 cases are good news, the end of the pandemic could mean millions of Medicaid recipients will lose their coverage. Federal law has prevented states from terminating Medicaid benefits while the coronavirus health emergency is in place.

The Secretary of Health and Human Services declared a nationwide public health emergency for COVID-19 in March 2020. In light of the public health emergency, Congress passed a law that provided that for Medicaid recipients who were enrolled in Medicaid as of March 18, 2020, the state (provided it accepted expanded Medicaid funds during the crisis) could not terminate their benefits even if there was a change in circumstances that would normally cause their benefits to be stopped. The law states that Medicaid coverage must continue through the end of the month in which the Secretary declares that the public emergency has ended.

The Biden administration has extended the health emergency through April 15, 2022, but states expect the public emergency to end sometime this year, meaning they will soon need to begin reevaluating whether millions of Medicaid recipients are still eligible for benefits. The Centers for Medicare & Medicaid Services (CMS) is giving states up to 12 months after the emergency expires to restart normal income eligibility redeterminations for Medicaid enrollees.

The impact on elderly Medicaid recipients receiving long-term care benefits is unclear, but an analysis by the Urban Institute  estimates that about 15 million non-elderly people could lose their Medicaid enrollment during the redeterminations. Many of those recipients may be eligible for subsidized insurance through the public marketplace, but it will be a lot of work to ensure that people understand their options and don’t lose insurance. States are asking the federal government for a firm date on when the policy will end to allow them to prepare, as well as more resources to handle the workload.