The expanded funding stems from a coronavirus relief measure Congress approved in March 2020. It provides states with a 6.2 percentage point increase in their federal match rate for most enrollees. In return, states have not been allowed to drop residents involuntarily from Medicaid coverage during the public health emergency, which is currently set to expire in mid-July.
States are expected to spend a total of $47.2 billion from fiscal year 2020 through fiscal year 2022 to cover the additional people enrolled in Medicaid because of the continuous coverage requirement, according to the Kaiser analysis. The enhanced federal match estimate is over the same time period .
Support for states
The augmented Medicaid match was designed to quickly provide broad fiscal relief for states, said Robin Rudowitz, director of Kaiser’s Program on Medicaid and the Uninsured and co-author of the analysis. The federal government also temporarily increased the match rate as part of the American Recovery and Reinvestment Act of 2009 to help states contend with the economic fallout from the Great Recession.
Fewer enrollees after emergency ends
But it is expected to plummet once the public health emergency ends and states are once again allowed to review eligibility for coverage — which could start as soon as August 1 if the declaration is not renewed.
Enrollees could lose coverage because they no longer meet income or other criteria or because of administrative barriers, such as failing to receive or properly fill out the renewal paperwork.
States will be largely responsible for reaching out to their residents to determine if they remain eligible and, if not, to help them shift to other policies, such as on the Affordable Care Act exchanges. They have 14 months to complete the eligibility checks.
“How states implement the unwinding of the continuous enrollment requirement will make a really big difference in how many people are able to retain coverage,” Rudowitz said.
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