Research Report What Will Happen to Unprecedented High Medicaid Enrollment after the Public Health Emergency?
Matthew Buettgens, Andrew Green
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Medicaid enrollment has risen substantially since the start of the COVID-19 pandemic. Recent data show enrollment jumped by more than 9 million people from February 2020 to January 2021. The higher enrollment is driven by two main causes: the unprecedented pandemic-related job losses concentrated in March to June of 2020 and the continuous coverage requirement of the Families First Coronavirus Response Act, which prohibits state Medicaid agencies from disenrolling beneficiaries during the public health emergency (PHE). Even as the economy improves, however, the continuous coverage provision is likely to contribute to even higher Medicaid enrollment through 2021. We estimate that by the end of 2021, 17 million more nonelderly people will be enrolled in Medicaid than before the pandemic, and we estimate that the number of Medicaid enrollees could decline by about 15 million people in during 2022 after the public health emergency is expected to expire.

A recent change in guidance from The Centers for Medicare & Medicaid Services (CMS) gives states up to 12 months to restore normal income eligibility redeterminations for Medicaid enrollees once the PHE expires. More gradual processing of enrollment over 12 months by states could reduce unnecessary losses of coverage by allowing more time for planning, outreach, and coordination with the Marketplaces. However, the expected loss of enhanced FMAP in March 2022 gives states a financial incentive to process enrollment more quickly.  

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