As part of the COVID-19 federal Public Health Emergency, states paused Medicaid disenrollment in exchange for increased federal funding, allowing Medicaid beneficiaries to remain continuously enrolled without eligibility redeterminations. This policy led to record historic growth in Medicaid and the Children’s Health Insurance Program (CHIP), increasing from roughly 72 million people in March 2020 to more than 92 million by December 2022. In late 2022, Congress passed legislation to end the continuous coverage provision, and states, including Texas, resumed eligibility redeterminations starting April 2023.
While administrative data show the number of enrollees losing Medicaid coverage, they do not track enrollees’ coverage transitions nor offer insights into how unwinding is affecting enrollees’ access to and affordability of medical care. Federal surveys, regarded as the gold standard, will eventually shed light on some of these dynamics, but these numbers are subject to considerable time lag.
This research brief summarizes the topline findings from a recent survey in Texas and three other states where we examined the “unwinding” of the Medicaid continuous enrollment provision on health care coverage, access and affordability to care, as well as other other major health policy issues.
Access the full JAMA Health Forum here.
