Health Policy Center
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Health Policy Special Update








Last week, the US Department of Health and Human Services renewed its declaration of a
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public health emergency because of the COVID-19 pandemic for the ninth time since January 2020. The renewal signals concern about continued surges and keeps emergency health coverage in place—at least temporarily.


Although Congress has boosted support to states that provide Medicaid and CHIP coverage during the public health emergency, states must act to minimize unnecessary coverage losses among the millions who could lose Medicaid eligibility after the emergency.


Congress has yet to take action on extending the enhanced premium tax credits (PTCs) made available through 2022 under the American Rescue Plan Act (ARPA). If these additional subsidies are allowed to expire, many more people will become uninsured. People leaving Medicaid will find it more difficult to afford Marketplace coverage.


While potential losses in coverage are looming, a proposed rule change to fix the so-called family glitch would, in contrast, help hundreds of thousands of families better afford coverage.

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What if the ARPA premium tax credits expire?
Without an extension on the enhanced PTCs, 3.1 million more people will be uninsured, and the non-Hispanic Black population, young adults, and low-income people will experience the largest coverage losses.

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Changing the “family glitch” would make health coverage more affordable for many families
If policymakers change the rules for PTC eligibility, 710,000 more people could enroll in Marketplace coverage with PTCs, and just over 90,000 more people could enroll in Medicaid or CHIP. Families switching to the Marketplace would save nearly $400 per person per year in premiums.

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What will happen to Medicaid enrollees’ health coverage after the public health emergency?
We project up to 16 million people will lose Medicaid coverage over the 14 months following the pandemic. But states can take steps to minimize unnecessary disenrollment and help those losing Medicaid enroll in other coverage.

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Preparing for the biggest coverage event since the Affordable Care Act
To help millions of people avoid falling off the health care cliff after the public health emergency, state officials are working to overcome barriers like lack of lead time, workload and staffing challenges, lack of data, and technology glitches.

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Promoting continuous coverage during the postpartum period
Medicaid’s role for postpartum coverage changed because of the pandemic’s continuous enrollment requirement. Case study participants from four states shared opportunities to promote continuous postpartum coverage after the public health emergency ends.

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