1 year ago

More than 10 million people have been disenrolled from Medicaid, based on data available from 50 states and the District of Columbia as of November 1, 2023. Disenrollment rates range from 65% in Texas to 10% in Illinois, according to KFF’s ongoing tracking. Differences in state renewal policies and system capacity likely explain some of this variation.

Some disenrolled individuals are regaining Medicaid coverage. As a result, overall declines in Medicaid enrollment will be less than the number of people disenrolled.

Other disenrolled individuals may have enrolled in, or be eligible for, other coverage, such as ACA Marketplace plans or employer coverage. The Medicaid unwinding could have implications for enrollment in the marketplaces:

• New flexibilities will extend Marketplace enrollment opportunities. Under a new, temporary “Medicaid Unwinding Special Enrollment Period,” available in the Federal Marketplace, Healthcare.gov, and in some state-based Marketplaces, people losing Medicaid between March 31, 2023, and July 31, 2024, can apply to the Marketplace with an attestation of Medicaid or CHIP loss and select a new plan within 60 days (90 days starting January 2024) of applying. In other State-based Marketplaces, people will have up to 120 days from the date of their Medicaid disenrollment to apply for Marketplace coverage.
• Marketplace enrollment could increase for the fourth straight year. The number of people who enrolled in Marketplace coverage earlier this year reached 15.7 million, surpassing prior record-setting years in 2021 and 2022.
• However, enrollment challenges may arise. Those who are not aware of their options for Marketplace coverage could be left uninsured. KFF’s updated Marketplace subsidy calculator and 300+ FAQs can help people purchase insurance.

“While Medicaid disenrollments are currently climbing at a fast rate, we don’t yet know how the unwinding will impact broader coverage trends,” says Jennifer Tolbert, director of the State Health Reform and Data Program at KFF. “There are several paths to health coverage for those who are no longer eligible for Medicaid – through the Marketplace and its subsidies, employers, or Medicare. The big question now is if people will find and navigate to other coverage or if they will become uninsured.”

Overall, 35% of people with a completed Medicaid renewal have been disenrolled in reporting states, while 65% have had their coverage renewed. As of October, states have reported renewal outcomes for three in ten of all people who were enrolled in Medicaid in March 2023 and for whom states must redetermine eligibility during the unwinding.

Children currently account for about four in ten (39%) Medicaid disenrollments in the 20 states reporting age breakouts. At least 1,881,000 children had been disenrolled out of 4,841,000 total disenrollments in the 20 states.

The data in KFF’s Medicaid Enrollment and Unwinding Tracker come from a variety of sources, including baseline and monthly reports that states submitted to the Centers for Medicare & Medicaid Services (CMS), state websites, and data released by CMS.