On March 18, 2020, in response to the outbreak of COVID-19 in the United States, the Families First Coronavirus Response Act (FFCRA) was signed into law. The FFCRA included a provision requiring state Medicaid programs to keep people enrolled, in exchange for additional federal funding. This continuous enrollment provision lasted for three years, ending on March 31, 2023, and states were able to resume disenrolling people from Medicaid who no longer met eligibility requirements or who did not complete the renewal process beginning on April 1, 2023. This process of conducting redeterminations for all Medicaid enrollees has been commonly referred to as “Medicaid unwinding.”

Since the start of Medicaid unwinding, KFF state tracking shows that more than 20 million people have been disenrolled from Medicaid, with states reporting renewal outcomes for two-thirds of enrollees so far. To shed light on the experiences of people who tried to renew their coverage or find a different source of health coverage during this period, KFF interviewed 1,227 U.S. adults who had Medicaid coverage in prior to April 1, 2023 – as states began the process of determining who was still eligible for Medicaid in their state. This report highlights people’s experiences with the Medicaid unwinding process and measures the financial and health impacts of being disenrolled from Medicaid and/or having to find other forms of coverage. While the scale of the unwinding is unprecedented, the survey findings can help policymakers understand how to improve the Medicaid renewal process more generally going forward.

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