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Medicaid Unwinding

HHS Reminds States of Legal Obligations to Federal Civil Rights Protections as States Transition from Medicaid Continuous Coverage Changes as the Public Health Emergency Ends – April 5, 2023

OCR has issued a letter, reminding states of their obligations under federal civil rights laws as the Public Health Emergency for COVID-19 and the continuous Medicaid coverage comes to an end, and states restart Medicaid and Children’s Health Insurance Program (CHIP) eligibility reviews.  The Families First Coronavirus Response Act (FFCRA) allowed for continuous Medicaid and CHIP coverage during the COVID-19 Public Health Emergency.  The expiration of this requirement presents the single largest health coverage transition event since the first open enrollment period of the Affordable Care Act.  As a result of the Consolidated Appropriations Act, 2023, this continuous enrollment condition ended March 31, 2023; states must, over time, return to normal eligibility and enrollment operations, in a process referred to as “unwinding.” As states begin unwinding, they are communicating with individuals and families to receive more information to make a coverage decision, provide information on eligibility and marketplace plans, and send people a renewal letter in the mail. Most children can still be covered through the Children’s Health Insurance Program.  The letter makes clear that states have independent obligations under federal civil rights laws to ensure that individuals and families continue to have access to Medicaid and Children’s Health Insurance Program coverage upon the expiration of the FFCRA continuous enrollment condition.

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