By Juliana Zhou 

One of the few silver linings of our bleak public health reality throughout the COVID-19 pandemic is that child health insurance coverage under Medicaid and the Children’s Health Insurance Program (CHIP) is at an all-time high. Due to temporary protections against Medicaid disenrollment, about 41 million children are insured through Medicaid or CHIP as of August 2022–greater than the population of California.  

The long-term benefits of Medicaid enrollment on the health and wellbeing of children–particularly young children between the ages of 0 and 3–are well documented. Medicaid covers half of all babies born in the United States, which is 40 percent of all children. Study after study has shown that childhood Medicaid coverage is associated with long-lasting benefits to overall health, educational attainment, and financial stability.  

However, temporary continuous coverage protections originally implemented as part of the COVID-19 pandemic response will end on March 31, 2023. This means that states will resume normal Medicaid renewal processes for all enrollees. Specifically, states will disenroll people who don’t complete the process or are newly ineligible for coverage. Policy advocates estimate that more than 6.7 million children are at risk of losing coverage if there is not a collective effort to ensure that all eligible children remain enrolled in Medicaid. State administrators, service providers, advocates, and parents/caregivers must all take proactive steps to ensure that children are not improperly disenrolled from Medicaid when states begin the massive administrative undertaking of restarting the re-enrollment process in the coming months. 

Everyone committed to protecting the health of children must take preventative action to ensure that children experience as little disruption to their health care coverage as possible. Families may need help understanding the paperwork they receive from the state and navigating the renewal process. The families who moved during the pandemic and did not update their mailing address or other contact information with their state Medicaid agency are at highest risk of disenrollment. Past disenrollment research shows that children who are unstably housed and Latinx children are also at greater risk of coverage disruptions. This means that Medicaid disenrollment creates greater instability for vulnerable children and their families in an already unstable situation. 

To prevent young children from being mistakenly disenrolled from Medicaid at a critical point in their development, everyone in the community–parents/caregivers, health care providers, early childhood professionals, and advocates–all need to spread the word that Medicaid enrollees must update their contact information with their states and complete the renewal process. We have listed some actions that different stakeholders can take below. 

Recommendations for Parents and Caregivers: 

• Make sure the state’s health agency has your most up-to-date mailing address and contact information. The Georgetown University Center for Children and Families provides this resource for advocates that includes information about how you can update your contact information with a state’s Medicaid agency (see Column D). 
• Look out for and respond to any mailings from your state health agency as soon as possible. 
• Spread the word by telling friends and family–even if Medicaid isn’t relevant to you, someone in your social circle might need to know. Most adults in Medicaid-enrolled families are completely unaware that Medicaid renewals will resume in 2023. 

Recommendations for Health Care and Early Childhood Professionals: 

• Spread the word–let your client/patient/family networks know. Consider posting fliers in your building or doing specific outreach to clients detailing the need to provide current contact information to the state and what to keep an eye out for in any mail and/or email from the state Medicaid agency. 
• Encourage Medicaid enrollees to update their contact information with the state.  
• If someone was covered by Medicaid early in the pandemic, they may still have coverage but not be aware. Encourage them to check their enrollment status and update their information if needed.  

Recommendations for Advocates: 

• Educate partner organizations about the end of continuous Medicaid enrollment and its potential impact on young children. 
• Bring the stories of families who lose coverage to policymakers/administrators. 
• In addition to promoting awareness, state health advocates can take several additional steps to minimize confusion and improper disenrollment. 
• Familiarize yourself with the guidance and resources that the Centers for Medicare & Medicaid Services provides states to prepare for the restart of Medicaid renewals. 
• Familiarize yourself with your state’s unwinding plan and available resources.  

Although many eligible children are at risk of losing Medicaid or CHIP coverage in 2023, that outcome is by no means guaranteed. We can all work together to ensure that children and their families have access to care.