The Medicaid Unwinding Explained - Compass Insurance Advisors
  • The Medicaid Unwinding Explained!

    What is the Medicaid Unwinding?

    At the start of the COVID-19 pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA). This ensured that people would have access to continuous health coverage through Medicaid and CHIP, even if their eligibility changed. 

    This resulted in 19.8 million people -a 27.9% increase- enrolling in Medicaid February of 2020.

    Congress put an end to the continuous enrollment provision, this will take effect on March 31, 2023. Those currently on Medicaid will automatically be put through a state-run process to redetermine their eligibility to remain on Medicaid.

    Who is affected?

    According to the Centers for Medicaid Services (CMS) it is estimated that approximately between 7-9 million people will lose Medicaid coverage during the unwinding period. 

    States have 12 months to complete their redetermination for all enrollees starting by April 1st.

    If someone is determined to be ineligible for re-enrollment with Medicaid, they will most likely fall into one of the following categories.

    Marketplace coverage, Employer coverage, or the Family Glitch.

    Options for New Coverage

    Marketplace coverage: Millions of those denied reacceptance for Medicaid coverage will qualify for an APTC to obtain affordable coverage through the marketplace. 

    Those who are ineligible to return to Medicaid are eligible for a Special Enrollment Period (SEP)  to enroll in marketplace coverage. 

    The marketplace has created a unique SEP for those losing Medicaid that runs from March 31st 2023 all the way to July 31st 2024.

    Once consumers attest they are losing Medicaid coverage and select a plan their marketplace coverage will begin on the first day of the following month.

    Employer coverage: If someone is offered affordable insurance through their workplace, they  themselves are not eligible for an APTC.

    Family Glitch: Before recent changes, a family’s eligibility for subsidized health plans was determined by the affordability of the employee’s health plan cost—regardless of the cost of a family plan.

    Regulations for this were changed for the 2023 Open Enrollment Period to allow more access to federally-subsidized healthcare for families with high-premium employer plans. 

    The new regulations allow an employee’s family to be enrolled in a subsidized marketplace plan when the employer-sponsored family plan costs more than 9.12% of the gross household income. Connect with a Compass Insurance Advisor to get more information on navigating the Family Glitch

    How to Find New Health Insurance Coverage

    If you are losing Medicaid coverage, you have a few options for finding a new plan.

    While you could go directly to to see what you qualify for, Compass Insurance has local experts that can guide you through that process and ensure you receive the maximum benefits you qualify for. 

    Working with our advisors is at no cost to you. They can help you shop for a new plan, understand your benefits, simplify the enrollment process, help with any follow up requirements, and will be your go-to person throughout the entire year if you have any questions about your policy or claims. And, did I mention you get that added help and it doesn’t cost you anything?

    Contact us today and we’ll help you find the right solution to replace your ending Medicaid coverage. We look forward to helping you soon!

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