The End of Medicaid Continuous Coverage: Programmatic and Rate Setting Considerations

Medicaid enrollment grew significantly during the COVID-19 pandemic, primarily because of a moratorium on member redetermination activities required to receive enhanced federal funding. In many cases, the significant growth in Medicaid enrollment also has affected average population acuity (i.e., cost). Significant Medicaid disenrollment in the coming months contributes to budgetary uncertainty for states and may result in somewhat elevated financial risk for contracted health plans. State-specific actions could mitigate this uncertainty to some extent. This paper explores the risk and potential state-specific actions that could mitigate this uncertainty.