Over 25 Million People Lost Medicaid Coverage. If You Were One of Them, Here Is What to Know.

For three years during the COVID-19 pandemic, states were not allowed to disenroll anyone from Medicaid. It was called the continuous enrollment requirement, and it was a federal protection that kept millions of people covered even if their income or circumstances changed. When that protection ended in April 2023, states had to do something they had not done since early 2020: check whether everyone currently enrolled was still eligible.

The process that followed is known as the Medicaid unwinding, or redetermination. By the time it was substantially complete in mid-2024, over 25 million people had been disenrolled from Medicaid and CHIP combined, according to KFF tracking data drawn from state and federal reporting. Some were no longer eligible. Many others lost coverage not because they were ineligible, but because of procedural problems: outdated addresses, forms not received, paperwork not returned in time.

If you were among those 25 million, you may now be uninsured, on a new plan you did not fully choose, or navigating an insurance system for the first time. This post explains what happened, who was most affected, and what your options look like now.

How the Continuous Enrollment Requirement Worked

The continuous enrollment requirement was established by the Families First Coronavirus Response Act of 2020. As a condition of receiving enhanced federal Medicaid funding during the pandemic, states agreed not to disenroll any Medicaid enrollee, even those who would ordinarily have become ineligible due to income changes, address changes, or failure to complete annual renewal paperwork.

Before the pandemic, Medicaid enrollment was approximately 71 million people. By April 2023, when the continuous enrollment provision ended, enrollment had grown to a record high of 94 million people in Medicaid and CHIP combined.

When the unwinding began, states had 14 months to work through their backlogs. The scale of what followed was substantial.

What the Numbers Actually Show

According to KFF's analysis of state and federal data through June 2024, over 25 million people were disenrolled during the unwinding, while over 56 million had their coverage renewed. Nationally, about 31 percent of people whose coverage was redetermined during the unwinding were disenrolled. But that number varied dramatically from state to state.

Five states had disenrollment rates above 50 percent: Montana, Utah, Idaho, Oklahoma, and Texas. Five states had disenrollment rates below 20 percent: North Carolina, Maine, Oregon, California, and Connecticut.

A significant portion of disenrollments were what advocates called "procedural disenrollments," meaning people lost coverage not because they were found ineligible, but because the paperwork process broke down. Outdated addresses meant notices never arrived. Some states had backlogs in processing returned forms. In many cases, people who were still eligible for Medicaid lost coverage anyway.

Children were disproportionately affected by procedural disenrollments. A 2023 analysis by Georgetown University's Center for Children and Families found that children accounted for a substantial share of early disenrollments, in many cases because their renewals were handled separately from their parents'.

What Your Options Are Now

If you lost Medicaid coverage during the redetermination period and you have not found new coverage, several pathways exist.

First, it is worth checking whether you are still eligible for Medicaid and were disenrolled in error. Every state allows you to reapply for Medicaid at any time. If you have not had a significant income change, you may still qualify. Go to your state's Medicaid agency website or Healthcare.gov to start an application.

Second, if your income is above the Medicaid threshold in your state, you may be eligible for a subsidized plan through the Affordable Care Act marketplace at Healthcare.gov. A loss of Medicaid coverage qualifies you for a Special Enrollment Period, meaning you do not have to wait for the annual open enrollment window.

Ellen can help you understand what your denial actually says and what to do next. Start here