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Medicaid Redetermination: Ensuring Americans Are Enrolled in the Right Coverage

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Medicaid is an essential part of American health care. It provides access to, and helps improve the health and financial security of Americans.

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Published on Feb 1, 2023

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Background

To ensure Americans had access to continuous health care coverage during the COVID-19 pandemic, the federal government provided states with additional federal funding in exchange for keeping individuals covered under Medicaid during the course of the public health emergency (PHE). This continuous enrollment requirement meant states put on hold the process of annually determining a person’s Medicaid eligibility.

As a result of the Consolidated Appropriations Act of 2023 passed by Congress, states may resume the process of redetermining individuals’ Medicaid eligibility as early as February 2023 and may end Medicaid coverage for individuals who do not demonstrate they are still eligible for the program starting April 1. With the continuous enrollment requirement decoupled from the end of the PHE, states are developing redetermination action plans and timelines which may take no longer than 14 months. Health insurance providers have been working alongside states to be essential partners in ensuring smooth operations and outreach.