Beginning in April 2023, most states began “unwinding” the pandemic-related continuous coverage requirement in Medicaid, which prohibited states from disenrolling Medicaid enrollees during the public health emergency. The unwinding process revealed that many states’ systems and renewal processes have been out of compliance with federal requirements, with some compliance issues disproportionately affecting children. 

In this Health Affairs Forefront blog post, the authors propose that the Centers for Medicare & Medicaid Services could provide stronger federal oversight and accountability for improving Medicaid eligibility and redetermination systems to ensure eligible children retain coverage.