Enrollment

This brief reviews what we know about Medicaid enrollment changes during economic downturns, examines unemployment-linked Medicaid enrollments early on in the COVID-19 pandemic, and considers the implications for the unwinding of the national public health emergency (PHE).

Medicaid enrollment increased since the start of the pandemic, primarily due to the continuous enrollment provision. KFF estimates that between 8 million and 24 million people will lose Medicaid coverage during the unwinding of the continuous enrollment provision. The Medicaid continuous enrollment provision stopped “churn” among Medicaid enrollees. States approaches…

As states begin to unwind the COVID emergency continuous enrollment provision and resume Medicaid disenrollments, early data from a handful of states – highlighted on KFF’s regularly-updated Medicaid Enrollment and Unwinding Tracker — reveal wide variation in disenrollment rates.

The unwinding of the continuous enrollment provision will play out differently across the states based on policy choices states have made and variation in their administrative infrastructures. Some states have adopted multiple policies that are more likely to promote continued coverage among those who remain eligible.

A KFF survey of Medicaid enrollees largely fielded prior to states resuming their efforts to redetermine Medicaid enrollees’ eligibility reveals many enrollees are unprepared for the renewal process that could result in some losing their coverage either due to eligibility changes or paperwork issues. During the COVID-19 pandemic, states suspended…

This brief gauges Medicaid enrollees’ knowledge of the Medicaid renewal process and possible disenrollment, following the end of continuous enrollment on March 31, 2023.

A new KFF analysis finds that an estimated 1.7 million Medicaid enrollees could become ineligible for federal Medicaid under proposed work requirements and presents state-by-state projections, based on estimates of coverage loss from the Congressional Budget Office (CBO). States could continue to provide Medicaid to those enrollees but would not…

The pandemic continuous enrollment provision and other research show that continuous eligibility reduces Medicaid disenrollment and “churn” rates and helps to ensure stable coverage. As many Medicaid enrollees are currently experiencing disruptions in coverage as a result of the Medicaid unwinding, a number of states are pursuing strategies to help promote continuity of coverage, including through unwinding waivers and Section 1115 demonstration waivers. This Waiver Watch summarizes approved and pending Section 1115 waivers with continuous eligibility provisions for children and adults in Medicaid.

State legislatures are currently gathering to develop new budgets for state fiscal year (FY) 2025. Heading into this budget cycle, state fiscal conditions are shifting, with state revenues starting to decline following steep revenue growth during the pandemic. This issue brief examines trends in state fiscal conditions and discusses how state budgets and macroeconomic conditions may affect individuals and state Medicaid programs.

This issue brief provides an overview of Medicaid spending and enrollment growth with a focus on state fiscal years 2022 and 2023. Findings are based on data provided by state Medicaid directors as part of the 22nd annual survey of Medicaid directors in states and the District of Columbia conducted by KFF and Health Management Associates (HMA). Findings examine changes in overall enrollment and spending growth.