Health Affairs December 1, 2023
Leighton Ku, MaryBeth Musumeci, Sara Rosenbaum

The process of unwinding Medicaid’s continuous enrollment guarantee, a special emergency public health protection for vulnerable Americans enacted early in the COVID-19 pandemic, is now in its eighth month. Between April and November 2023, more than 11 million Medicaid beneficiaries have been disenrolled; millions more will lose coverage in the coming months. The purpose of the special continuous enrollment guarantee was to ensure that people would retain insurance during a pandemic characterized by its highly communicable nature and its severe impact on health. Over the continuous enrollment guarantee period, Medicaid enrollment grew from 64 million in February 2020 to about 86 million by January 2023.

Legislation requiring states to unwind—that is, restore normal Medicaid eligibility redetermination procedures—gives states the flexibility...

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