Learn about the unwinding of the Medicaid continuous coverage provision

Written by: Children's Campaign
Date Posted: May 13, 2022

In March 2020, Congress provided increased Medicaid funding to states as part of COVID-19 relief legislation. To receive this funding, states had to meet certain requirements, including a “continuous coverage” provision that prohibits them from ending a majority of Medicaid enrollees’ coverage until the Public Health Emergency (PHE) is declared over.  

This provision has allowed millions of people to remain covered in the ongoing public health crisis – and it is likely a major reason why the rate of uninsured Americans has not gone up. With the PHE recently extended to mid-July, continuous coverage will begin “unwinding” on July 31, meaning individuals could lose coverage as soon as Aug. 1.   

During the unwinding process, states will resume their annual Medicaid eligibility reviews, with tens of thousands of enrollees estimated to lose coverage or experience coverage gaps. Advocates will play an essential role during this process to ensure states adopt a strategic approach to unwinding coverage. Georgetown University Public Health Institute’s Center for Children and Families (CCF) has provided a comprehensive guide for advocates on how to effectively engage in this process.  

The analysis recommends several steps states can take to reduce the risk of coverage losses at the end of the PHE, including eliminating annual premiums for CHIP plans – especially for those under 200% of the Federal Poverty Level (FPL). Prior to the PHE, Colorado was one of the few states charging premiums for CHIP – called CHP+ in our state – including to those at income levels as low as 150% FPL. Cover all Coloradans, which passed the legislature this week, eliminated all CHP+ premiums in Colorado.  

Despite this progress, the risk of coverage loss at the end of the PHE is substantial. The Georgetown Center on Children and Families and American Academy of Pediatrics are advocating that the PHE be extended to minimize coverage losses, which are projected to be greatest among families facing the most systemic barriers to accessing coverage, including families of color and those who speak a first language other than English. It is estimated that nationwide, 7 million children may lose coverage at the end of the PHE. 

On May 18, CCF will be hosting part seven of their webinar series “Unwinding the COVID-19 Medicaid Continuous Eligibility Provision.” This presentation focuses on what the end of the PHE means for Medicaid eligibility, and how advocates can engage in their state’s planning process and monitor implementation. To register, click here. 

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The Colorado Children’s Campaign is a nonprofit, nonpartisan advocacy organization committed since 1985 to realizing every chance for every child in Colorado. We advocate for the development and implementation of data-driven public policies that improve child wellbeing in health, education and early childhood. We do this by providing Coloradans with trusted data and research on child wellbeing and organizing an extensive state-wide network of dedicated child advocates. For more information, please visit www.coloradokids.org.