Not a Moment to Lose: Critical Changes States Should Implement to Prevent Medicaid Coverage Losses

If states do not act, many of the over 88 million people who rely on Medicaid and the Children’s Health Insurance Program (CHIP) for their health insurance could lose their coverage when the federal COVID-19 public health emergency (PHE) expires. Once the PHE’s continuous coverage requirement ends, states will resume their pre-pandemic processes for establishing whether a person continues to qualify for Medicaid — known as redeterminations.

If not done with considerable planning and care, this resumption could result in unnecessary coverage losses. Federal law requires states to make the process easier for beneficiaries by increasing automated renewals instead of relying only on mailed notices. As the end of the PHE and restart of redeterminations loom on the horizon, states should do everything in their power to renew coverage for people who remain eligible, especially when readily available data can often confirm eligibility.

This paper presents state advocates with:

1. Pertinent information on the ex parte process and the PHE.
2. Clear, achievable goals to champion in their respective states.
3. A checklist of vital changes to pursue to increase ex parte rates in the time remaining before the PHE ends.