How Can Families Prepare for Medicaid Unwinding?

(February 24, 2023) State Medicaid programs are preparing for a major change to their coverage – a return to the pre-pandemic process of determining eligibility. Early in the COVID-19 public health emergency (PHE), Medicaid started operating under a continuous coverage requirement. As a result, Medicaid recipients have not had to re-enroll for the duration of the PHE. This requirement has helped to significantly decrease the uninsured rate for children.

As a part of the omnibus bill signed in December 2022, Congress delinked the PHE and the Medicaid continuous coverage requirement, naming the end of March the end of the requirement. The process of redetermining each participant’s coverage eligibility – known as the unwinding – will take a year, but families shouldn’t wait to update their information.

Even prior to the pandemic, Medicaid struggled to keep in touch with their recipients. Barriers to communication include language, change of address or phone, lack of stable internet or technology, or simply having other major life challenges. It’s essential for families to know that they will need to redetermine their Medicaid eligibility. It’s also necessary to educate healthcare providers and the general public to ensure eligible children don’t fall through the cracks.

Why all the anxiety?

Some families may not even know that they need to complete a yearly renewal process because they have only been on Medicaid and/or CHIP in the past few years. Due to this, families may be unaware that they have to report changes in the eligibility system such as:

  • Income
  • New Job
  • Household size
  • Address
  • Marital status
  • Insurance
  • Pregnancy status
Where should impacted families go?

In Pennsylvania, families can report changes mentioned above here:

Pennsylvanians interested in learning more or in need of further resources can visit:
https://www.media.pa.gov/Pages/DHS_details.aspx?newsid=891

It’s also important that parents/caregivers know that just because they are no longer eligible does not mean that their child/children are no longer eligible. Children who are no longer eligible for Medicaid can still apply for free or low cost CHIP, and all children should still have access to affordable healthcare.

Children’s insurance coverage rates will inevitably decrease during this process, but by working together, we can lessen the impact and ensure that eligible children don’t lose coverage due to administrative reasons.

How do I learn more?

Extensive research, advocacy, and outreach has been done in preparation for this process. Some recent articles digging deeper on the subject can be found here:

Cristina Codario, Allies for Children Health Policy Director