As part of the public health emergency declared by the federal government during the COVID-19 pandemic, people who were enrolled in Medicaid in states across the country were protected from losing it through a continuous coverage provision.  The idea was to keep as many people covered as possible with comprehensive, affordable health care during the first global pandemic in more than a century.

But when the public health emergency unwinds, this protection will be removed. This means about 15 million people across the country are projected to lose their Medicaid coverage as states revert back to business as usual. This PHE “unwinding” presents unique administrative challenges for states and the federal government as people enrolled in Medicaid move to other coverage. [See this blog by my colleague Tricia Brooks for more on the unwinding].

In a recent report, the federal government predicts that one group of 383,000 people — mostly working adults and parents — will not be eligible for any other affordable coverage when they lose their Medicaid.  Why?  They live in the 12 states that still have not expanded Medicaid. Their incomes will be “too low” for marketplace insurance subsidies but “too high” for getting Medicaid under the changed rules. So they will be back in the coverage gap. For non-expansion states, this will be an additional burden as they try to transition residents losing Medicaid to new coverage.

There’s an easy fix though! Non-expansion states can simply take advantage of the huge federal financial incentives available and join 38 other states around the country in expanding Medicaid.