With the Public Health Emergency (PHE) coming to end, the continuous coverage that was being provided by Medicaid without the need for re-determining the eligibility every month under the Families First Coronavirus Response Act will also end. This means, the people who do not complete the re-determination will lose the Medicaid coverage. It is imperative that the Federal Government, States, Insurance companies, Providers, Hospitals, and Billing Companies work together to help these patients. 

Deadlines and Timelines: 

The continuous Medicaid coverage will end on March 31, 2023, and the unwinding process will begin on April 1, 2023. States have 12 months to initiate redeterminations and 14 months to complete the process. 

People Impact: 

Enrollment will end for an estimated 5 million 15 million people depending on each state, with 8.2 million losing eligibility due to income changes, 6.8 million due to administrative churning, and 400,000 will lose coverage due to coverage gap. People aged 0-17 are likely to be affected the most, while those aged 65+ are the least to get affected. 

Statistics on Coverage: 

  • Medicaid and CHIP (Children s Health Insurance Program) enrollees increased by 20% since the PHE. 
  • Around 90 million people are currently covered. 
  • 9 states & DC have more than 25% of their population enrolled in Medicaid. 
  • New Mexico has the highest @ 34% and North Dakota, the lowest @ 10%.  

Things you can do as a Provider / Hospital / Billing Company: – 

  • Check the eligibility for coverage through online portals during each visit made by the patient. 
  • Collect the correct demographics and contact information, especially the mailing address, phone#, email address, etc. 
  • Educate patients on the Medicaid unwinding process and marketplace policies that will cost less if their coverage ends with Medicaid. 

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