CivicScience data from February found that two-thirds of Americans were looking forward to the official end of the COVID-19 pandemic as a federal public health emergency, which the Biden administration has set to expire in early May. However, the end of the emergency could also impact millions of recipients and families with Medicaid coverage.

Medicaid/CHIP enrollment grew by more than 20 million since the start of the pandemic thanks to a provision in the Families First Coronavirus Response Act, which required states to keep people continuously enrolled in Medicaid/CHIP. The act also enhanced federal funding for those programs. But as of April 1, the provision expired and states are beginning the redetermination process for recipients, potentially placing millions at risk of losing health insurance.

With more than 90 million Medicaid/CHIP recipients in the U.S., the current situation has many feeling worried. New CivicScience data find that 40% of U.S. adults currently enrolled in Medicaid and/or CHIP are concerned about losing their benefits due to the rollbacks in their state. One in four recipients say they are ‘very concerned’ about getting kicked off of Medicaid/CHIP.

Concern varies by demographics and political affiliation. Results show that young adult recipients are the most concerned about losing Medicaid insurance. An overwhelming 69% of current recipients aged 18-24 say they are concerned and 43% are ‘very concerned.’ Likewise, 57% of recipients aged 25-34 harbor concern. In comparison, concern greatly falls off among recipients over age 35, affecting just 29% of those aged 35-54.

Medicaid/CHIP recipients who identify as Democrats are twice as likely as Republican or Independent recipients to say they are ‘very concerned’ about the Medicaid redetermination process – 43% of Democrats, compared with 22% of Republicans and 24% of Independents.

Health insurance fallback plans vary significantly among recipients. For recipients who may be impacted by the changes to Medicaid/CHIP in their state, many say they will seek an alternative form of health insurance. Just 28% plan to apply for health insurance through the Affordable Care Act, although sources say the ACA’s income requirements could be a roadblock for Medicaid recipients who fall in the “coverage gap.”

After the ACA, Medicaid/CHIP recipients cite the next two best options as seeking insurance through an employer (16%) or simply going without health insurance altogether (15%). Many remain uncertain what they would do at this time if they lost their Medicaid insurance (17%).

The “coverage gap” is more likely to be a problem in certain states that have not adopted Medicaid expansion under the ACA, particularly in southern states. CivicScience data show Medicaid/CHIP recipients in the U.S. South are the most likely to be concerned about losing coverage (46%), whereas those in the U.S. Midwest are the least concerned (28%).

Lower-income households are also unsurprisingly the most at risk and the most likely to be worried about their insurance, with fewer earnings to put towards paying for a new health insurance plan. More than a third of current Medicaid/CHIP recipients who earn less than $50K annually say they’re ‘very concerned’ about losing coverage. The rollbacks come at a time when lower-income households also face cuts to SNAP benefits, which are impacting grocery buying habits.

States will determine on an individual basis who stays and who goes in the months ahead. The changes are unlikely to improve the alarmingly high percentage of young adults who are already avoiding doctor and ER visits due to high costs.

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