Medicaid Unwinding Winds Down: What We’ve Learned – Health Care in Motion

State Medicaid programs are at the tail end of an unprecedented reduction in Medicaid enrollment. States are reinstituting normal Medicaid redetermination and renewal processes, which were paused during the height of the COVID-19 pandemic. Because of the pandemic pause, Medicaid rolls swelled to record highs from 2020 to 2023. Starting in April 2023, however, states slowly but surely worked their way through every Medicaid member to determine who was still eligible for the program, resulting in a massive exodus of individuals. Many of those who lost coverage had changes in circumstances that made them no longer eligible, but many otherwise were terminated for procedural reasons, meaning they simply did not complete the renewal process. These individuals may still be eligible for coverage.

The Medicaid unwinding has been far from smooth sailing, creating administrative challenges for state Medicaid programs and confusion and disruptions in care and treatment for Medicaid members. The Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees the Medicaid program, had to balance the need to provide support to state Medicaid programs as they tackle waves of renewals while also holding the line on enforcement of consumer protections.

Read our latest Health Care in Motion to learn more about what the unwinding has meant for systemically marginalized groups and what lessons we’ve learned from this experience that should inform future policy changes.