Communicating about the Medicaid/CHIP Continuous Enrollment Unwinding in Rural Areas

The COVID-19 pandemic public health emergency (PHE) is set to expire on May 11, 2023. During the PHE, states had the option to maintain Medicaid and the Children's Health Insurance Program (CHIP) coverage without annual review of eligibility.

The process for states to “unwind” this expanded eligibility and return to normal enrollment for these programs is underway. The timing and specifics of how each state will handle this process will differ, but each state will have a 12-month period to complete the unwinding, once the process begins in that state.

The resources and information provided here can help rural providers, community organizations, and others understand the unwinding process and help to prepare Medicaid/CHIP enrollees to renew their coverage or find different health insurance coverage.

Key Resources for Understanding the Unwinding

Unwinding and Returning to Regular Operations after COVID-19
Medicaid.gov
Central resource for states and other Medicaid stakeholders to find information and resources to help them plan and prepare for the unwinding of continuous coverage.

Medicaid and CHIP Continuous Enrollment Unwinding: What to Know and How to Prepare, A Partner Education Monthly Series
Centers for Medicare & Medicaid Services (CMS)
Monthly webinar series covering different topics related to continuous enrollment unwinding. Materials from previous calls are available at CMS National Stakeholder Calls.

Unwinding the Medicaid Continuous Enrollment Provision: Projected Enrollment Effects and Policy Approaches
Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health & Human Services
Provides estimates for how many Medicaid enrollees are likely to lose coverage during the unwinding process and identifies other coverage options that may be available.

10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision
KFF
Provides an overview of how Medicaid continuous enrollment impacted coverage, requirements and options for states during the unwinding period, outreach options for informing enrollees about the upcoming changes, and potential impact of this transition on coverage.

Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies as States Prepare for the Unwinding of the Pandemic-Era Continuous Enrollment Provision
KFF
Identifies state actions to prepare for the lifting of the Medicaid and CHIP continuous enrollment provision. Covers key state Medicaid eligibility, enrollment, and renewal policies and procedures in place as of January 2023. Includes summary information across states, as well as state-specific information.

Timeline and Special Enrollment Period

Key Dates Related to the Medicaid Continuous Enrollment Condition Provisions in the Consolidated Appropriations Act, 2023
Centers for Medicare & Medicaid Services (CMS)
Explains key dates and processes for states during the unwinding process. Includes a timeline of activities.

Temporary Special Enrollment Period (SEP) for Consumers Losing Medicaid or the Children's Health Insurance Program (CHIP) Coverage Due to Unwinding of the Medicaid Continuous Enrollment Condition – Frequently Asked Questions (FAQ)
Centers for Medicare & Medicaid Services (CMS)
Provides information on how those who lose Medicaid or CHIP coverage due to the end of continuous enrollment can enroll in a Marketplace health insurance plan during the March 31, 2023-July 31, 2024 special enrollment period.

State Unwinding Activities

Anticipated 2023 State Timelines for Initiating Unwinding-Related Renewals As of February 24, 2023
Medicaid.gov
Lists the first month for unwinding-related renewals and the effective date of first anticipated terminations for each state.

50-state Unwinding Tracker
Center for Children and Families, Georgetown University Health Policy Institute
Provides information for each state's preparation for unwinding of Medicaid continuous coverage. Identifies whether each state has shared key documents and information about their process. A downloadable version that includes links to the relevant documents and websites is also available.

Communicating to Individuals About the Unwinding Process

Medicaid and CHIP Continuous Enrollment Unwinding: A Communications Toolkit
Centers for Medicare & Medicaid Services (CMS)
Provides key messages, sample articles, social media products, and other materials states and other Medicaid stakeholders can use to communicate about the unwinding of continuous coverage.

Strategic Approaches to Engaging Managed Care Plans to Maximize Continuity of Coverage as States Resume Normal Eligibility and Enrollment Operations
Centers for Medicare & Medicaid Services (CMS)
Describes strategies to get Medicaid/CHIP enrollee contact information and conduct outreach, in order to communicate about the upcoming coverage changes due to the unwinding of continuous coverage. Includes a set of scenarios for helping individuals renew or find new coverage.

Helping Consumers Navigate Medicaid, the Marketplace, and Employer Coverage
State Health & Value Strategies
Explains the need to educate those losing Medicaid coverage about other health insurance coverage options and identifies useful strategies for states.

Unwinding the Medicaid Continuous Coverage Requirement—Transitioning to Employer-Sponsored Coverage
State Health & Value Strategies
Describes the role that employer-sponsored health insurance coverage can play in helping those losing Medicaid coverage during the unwinding of continuous coverage.

FCC Takes Action to Ensure Americans Receive Critical Information on Health Care Coverage
Federal Communications Commission (FCC)
Describes guidance that will allow Medicaid enrollment calls and text messages without violating robocall and robotext prohibitions.

Related Additional Resources

What Happens After People Lose Medicaid Coverage?
KFF
Describes to what extent people who were disenrolled from Medicaid/CHIP in 2016-2019 enrolled in and retained other coverage in the year following disenrollment. Discusses the implications of this for people currently enrolled in Medicaid/CHIP, as states unwind continuous enrollment.