May 10, 2022 - Health

Millions could lose coverage when COVID public health emergency ends

Illustration of a person looking over the edge of a large cliff chasm shaped like a medical cross

Illustration: Annelise Capossela/Axios

Between 5.3 million and 14.2 million people could lose their health coverage when temporary pandemic-inspired reforms to Medicaid expire at the end of the public health emergency, according to a new Kaiser Family Foundation analysis.

The big picture: Democrats who hoped they'd enact transformational health legislation with control of the White House and Congress could instead face a historic jump in the U.S. uninsured rate.

Background: Congress in 2020 included measures in pandemic relief legislation that increased the share of federal Medicaid spending if states offered continuous coverage to enrollees, suspending the program's usual churn.

The extra allowances sunset with the end of the public health emergency, which is due to expire July 15 unless the Biden administration extends it again.

Go deeper: Kaiser examined scenarios for how states can determine whether their Medicaid enrollees are still eligible for coverage when policy changes hit the safety net program.

  • The biggest losses are expected to be among adults who gained coverage through the Affordable Care Act's Medicaid expansion, other adults eligible for reasons other than a disability, as well as children.
  • Medicaid enrollment is expected to grow 25%, or by 22.2 million people, from fiscal 2019 through 2022, mostly because of the pandemic-driven allowances, the researchers project.
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