Report predicts 3.8 million kids will lose Medicaid/CHIP coverage when the public health emergency ends

Written by: Children's Campaign
Date Posted: September 2, 2022

A recently released report from the Assistant Secretary for Planning and Evaluation’s (ASPE) Office of Health Policy highlights the catastrophic loss of health care coverage that millions of children and families will experience if policy action is not taken to extend Medicaid/CHIP coverage at the end of the public health emergency (PHE). Children are the group most likely to lose coverage at the end of the PHE, and the only group who are more likely to lose coverage due to paperwork errors than a genuine change in eligibility status. The report projects that 3 out of 4 kids who lose coverage at the end of the PHE will lose coverage due to administrative processing errors.

Since the onset of the pandemic, the Families First Coronavirus Response Act (FFCRA) has mandated continuous Medicaid enrollment throughout the duration of the COVID-19 PHE for people enrolled in Medicaid on or after March 18, 2020, while also suspending Medicaid’s regular eligibility renewal and redetermination process. Partly due to this provision, Medicaid enrollment grew to 86.7 million individuals by December 2021, and the nation’s uninsured rate hit a historic low of 8.0%. The same data show that the uninsured rate among children nationwide, which had increased during 2019 and 2020, fell from 6.4 percent in late 2020 to 3.7 percent in early 2022. (State-level estimates beyond 2020 are not yet available.) At the end of the PHE, all states will have 12 months to initiate the redetermination process for all people enrolled in Medicaid and Child Health Insurance Program (CHIP), and two extra months to complete all pending actions.  

 ASPE projects that an estimated 5.3 million children nationwide will lose their Medicaid/CHIP coverage, with 3.8 million of these children still being eligible for coverage. This is due to administrative churning, which is defined as the loss of coverage based on procedural reasons, such as the child’s parents not having an updated address on file with their state’s Medicaid provider. Black and Latinx individuals are also at a disproportionate risk of losing coverage. Currently, Latino individuals constitute one-third of individuals expected to lose coverage due to churn, and Black individuals make up 15 percent of this same group. 

According to the latest data provided by the Colorado Department of Health Care Policy & Financing (HCPF), all 1.6 million Coloradans enrolled in Medicaid and/or the Child Health Plan Plus (CHP+) will be required to go through the redetermination process once the PHE begins to unwind. As of April 2022, 581,587 of these individuals are in the continuous coverage group, meaning they are at risk of being disenrolled despite still being eligible for coverage. Estimates indicate that roughly 200,000 of these locked-in individuals are children.  HCPF has been leading an Update Your Address Campaign to aid Coloradans in the renewal process, with the goal that every family in Colorado has their updated address on file so that they can complete the redetermination process.  

Continuous eligibility policies can help mitigate Medicaid/CHIP coverage loss due to administrative churning. States have the option to provide 12 months of continuous coverage through Medicaid and CHIP, despite changes in income eligibility that a family may experience. Colorado currently offers the 12 months of continuous coverage option, and Medicaid/CHP+ coverage was recently extended in Colorado to 12 months for pregnant and postpartum people.  

Learn more about HCPF’s current plan for the PHE ending on their website, and check out the frequently asked questions (FAQs) webpage from the Center for Law and Social Policy (CLASP) to learn more about the PHE unwind. 

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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