The effect of ending the pandemic-related mandate of continuous Medicaid coverage on health insurance coverage

The Medicaid continuous enrollment provision, which ensured uninterrupted coverage for beneficiaries during the COVID-19 pandemic, was ended in March 2023. This unwinding process has led to large-scale Medicaid disenrollments, as states resumed their standard renewal process to evaluate enrolled individuals’ eligibility status. Our analysis investigates whether resumption of states’ renewal process has led to an increase in the risk of becoming uninsured for adults aged under 65. Using state-month variation in the timing of the first round of disenrollments, we first document a 6-12 percent decline in total Medicaid enrollments after states resumed their renewal process. Next, based on nationally representative samples of adults younger than age 65, we do not find statistically relevant effects on the probability of being without any health coverage. However, looking at different demographic groups, we see a one percentage point increase in the likelihood of becoming uninsured for adults who have a college education but do not have a bachelor’s or higher degree.