Millions of people lost Medicaid coverage during the post-pandemic redeterminations period.

As the health insurance program for low-income people in the U.S., including families and children, pregnant and post-partum individuals, the disabled, and the elderly, Medicaid provides health care coverage to millions of people. The program is run jointly by states and the federal government, and policies vary by state.

In general, Medicaid enrollees are required to verify their eligibility for the program each year. During the COVID-19 pandemic and ensuing public health emergency, the federal government allowed states to suspend this requirement. As a result, enrollees were able to stay on Medicaid, and overall enrollment in Medicaid increased. Starting in April 2023, the federal government required states to redetermine eligibility of all individuals enrolled in Medicaid. This is referred to as the “unwinding” of the continuous enrollment requirement, or Medicaid redeterminations.

The unwinding is a complex operational and policy challenge for state Medicaid agencies, managed care organizations, individuals enrolled in Medicaid, and those that support them.

NORC provided strategic direction, as well as policy and data analysis, to clients seeking to understand the Medicaid redeterminations period and its impact.

NORC worked with several clients, including AARP Public Policy Institute and AHIP, to develop tailored solutions to help them understand and adapt to the Medicaid unwinding. Our work included:

• Developing projection models to understand the potential impact of Medicaid redeterminations on specific outcomes (e.g., transitions to other coverage) and populations (e.g., older adults)
• Data analysis of state Medicaid data across multiple sources, including Centers for Medicare & Medicaid Services (CMS), KFF, Georgetown Center of Children and Families, and state Medicaid unwinding dashboards
• Novel analyses examining associations between specific state redetermination policies and renewal outcomes such as correlation between ex parte renewal rate and procedural termination rate
• Tracking, analyzing, and summarizing CMS and state policy updates related to Medicaid redeterminations, producing various ad hoc, time-sensitive deliverables