Medicaid’s “unwinding” — the redetermination process that resumed after the pandemic pause — has now moved more than 25 million Americans off Medicaid rolls since April 2023. A big chunk of them lost coverage not because they no longer qualified, but because paperwork didn’t reach them, wasn’t returned in time, or was returned wrong. That’s what the trade calls a “procedural disenrollment,” and it’s the story most people missed while it was happening in the background of everything else.
What’s less reported is where those millions ended up. The picture is uneven and it depends heavily on the state. (Sources: KFF Medicaid Enrollment and Unwinding Tracker, Georgetown CCF.)
Three doors, and one of them shuts on you if you wait
Broadly, three landing spots: (1) back onto Medicaid after reapplying and getting the paperwork right, (2) onto the Marketplace with a subsidy, or (3) uninsured. The third bucket is bigger than it needs to be — because the Marketplace Special Enrollment Period triggered by losing Medicaid runs 60 days from the date coverage ended, and a lot of folks don’t find out they’ve lost coverage until they show up at a pharmacy or a doctor’s office weeks after the fact. By then the clock is already ticking.
Craig’s Take
I get the calls from people who got the letter and didn’t open it because it looked like junk mail. I get the calls from people whose kids aged out of family Medicaid coverage and nobody explained the transition. I get the calls from newly self-employed folks whose income moved just enough to disqualify them, but the letter went to an old address.
Here’s what none of the coverage of “the unwinding” said in plain English: if you lost Medicaid and you’re still inside 60 days from your loss-of-coverage date, you’re in a Special Enrollment Period right now. Subsidies are usually significant at that income level. You do not have to wait for open enrollment. You do not have to be uninsured. But you do need to move. — Craig
What to Do
- Lost Medicaid recently? Check your loss-of-coverage date. If it’s within 60 days, you qualify for a Marketplace Special Enrollment Period.
- Not sure if you lost it? Log into your state Medicaid portal or call your state office. Do not assume no news is good news.
- If you got a redetermination letter and it’s been sitting in the pile, open it today. The reapplication window is often shorter than people think.
- Kids: state CHIP programs cover children in a lot of income situations where the parent doesn’t qualify. Don’t skip that.
Not sure how this affects your family? Book a free Healthcare Review or ask Lulu at insuredaf.com/diy/.
