What is Medicaid Unwinding?
In 2020, Congress enacted a requirement that Medicaid programs keep people continuously enrolled in Medicaid until the COVID-19 public health emergency (PHE) ends and increased federal funding to state programs through a temporarily enhanced Federal Medical Assistance Percentage (FMAP). The continuous enrollment provision is now scheduled to end on March 31, 2023. States can resume disenrollments beginning in April but must meet certain reporting and other requirements during the unwinding process. All Medicaid enrollees will be asked to provide information and go through a process to determine if they are still eligible for coverage.
Key Dates
- February 1 – last day for states to submit unwinding plans to CMS for states that started unwinding in February 2023
- February 15 – last day for all other states to submit unwinding plans to CMS
- March 31 – end of continuous eligibility period
- April 1 – first possible day for terminations (if state starts in Feb.)
- May 11 – projected end of the Public Health Emergency
- July 1 – last possible day for a state to begin terminations
- December 31, 2023 – enhanced FMAP for all Medicaid ends
- May 2024 – Last possible month to finish unwinding redeterminations (depending on when state started)
Overarching Resources from the Federal Government and Others
- This is the central page from the Center for Medicare and Medicaid Services (CMS) that will be kept up to date with all resources on Medicaid unwinding. Medicaid – Unwinding and Returning to Regular Operations after COVID-19
- CMS has created a central website for renewing Medicaid coverage, including links to state-specific websites. Renew Your Medicaid or CHIP Coverage | Medicaid
- CMS – Medicaid Unwinding Frequently Asked Questions
- CMS – Medicaid and CHIP Renewal Requirements
- CMS – Unwinding Timeline (state by state)
- CMS has created many tools for sharing information with the public on what patients, providers and others need to do to prepare for the Medicaid unwinding. CMS – Medicaid and CHIP Unwinding Communications Toolkit
- Here is information on how to identify local resources that can help you manage transitions in insurance if you lose Medicaid coverage. gov – Local Assistance for Health Insurance Application
- The Georgetown University Center for Children and Families has compiled a resource to get specific state-by-state information about the unwinding process. Georgetown University – 50-state Unwinding Tracker
- Information from CMS to states on how to minimize coverage loss by undertaking automatic re-enrollment for some people. CMS – Ex Parte Renewal PPT
- CMS information on how the end of continuous enrollment affects Medicaid waivers. CMS – Coronavirus waivers
- The complete Medicaid and CHIP Eligibility Renewals Communications Toolkit is available in Spanish, and select materials are available in five additional languages, which include:
CMS Technical Guidance
NHC Member resources
- American Lung Association – Important Changes That Could Impact Your Healthcare Coverage
- Epilepsy Foundation site with helpful tips for patients and families. Medicaid Changes | State Eligibility Changes 2023 (epilepsy.com)
- Hemophilia Federation of America – State Medicaid Websites
- Hemophilia Federation of America – Medicaid and CHIPS renewal Toolkit
- UnidosUS – Shrinking the Medicaid Cliff: How Congress Can Prevent Health Equity Disaster by Protecting Eligible Families’ Health Care
Unidos US toolkits containing key messages, draft social media language, graphics, and suggested hashtags in both English and Spanish to help educate the community about opportunities to enroll in affordable health coverage. Medicaid/CHIP Enrollment, Medicaid Unwinding, and ACA Open Enrollment Bilingual Toolkits | UnidosUS
Other Resources
- Center for Law and Social Policy – Help Kids Stay on Medicaid
- American Cancer Society Cancer Action Network – Unwinding Continuous Medicaid Coverage
- Georgetown University – Medicaid and CHIP Provisions Explained
- Justice in Aging – Fact Sheet: Unwinding Medicaid Continuous Coverage Protections
- Kaiser Family Foundation – Medicaid Unwinding – 50 State Survey
- Kaiser Family Foundation – 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision
- Kaiser Family Foundation – Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies as States Prepare for the Unwinding of the Pandemic-Era Continuous Enrollment Provision
- National Health Law Program – COVID19 PHE Unwinding
- National Health Law Program – Unwinding Medicaid Continuous Coverage Checklist
- National Health Law Program – PHE and Continuous Coverage Unwinding Resources
- National Health Law Program – Issues to monitor during Unwinding
- National Health Law Program – Medicaid policy recommendations
- State Health & Value Strategies – IT Systems and Data Strategies to Prepare for Medicaid Continuous Coverage Unwinding